Dear Andy,

Wow, it’s been a while since we last spoke. I’m about to start my junior year—can you believe that? It still seems like yesterday that you and I met through South Boston Afterschool. On the T-ride to South Boston, we talked in Chinese (I had just started; you helped me with my tones). We talked about girls (we talked a lot about girls). And sometimes we talked about more serious things. About how we were so afraid to fail, about how we constantly felt pulled in all directions. About how hopeless we felt.

When you quit South Boston Afterschool, I just figured it was a sophomore slump. Maybe your economics tutorial was taking up too much of your time, or maybe you were working on a new start-up, trying to be the next Mark Zuckerberg. You were stressed out the last time I saw you. I wasn’t too worried, though. I thought what everyone else here thinks: Junior year will be better than sophomore year. Senior year might be a bit tougher because of job searching, but you’ll be set after that. You’ll be a Harvard grad the rest of your life.

But then you jumped off a tower in downtown Boston. I thought wrong.

Andy, I spent a long time trying to figure out how to write this letter. It’s been on my mind every single day now for months. I almost gave up, because the words just wouldn’t come to me. It was too painful to express.

Then, in May, my best friend since we were babies ended his own life. He had just gotten into Georgia Tech. He had so much talent. He had such an incredible life ahead of him. His mom found his body. They couldn’t show it at the service.

His death inspired me to write this to you. Because it’s not just him, and it’s not just you. Writing this next part terrifies me, Andy. I’m scared because we live in a world where I can’t even write this letter without knowing in my heart that no matter what people will say, they will look at me differently. I want to make a big impact after I graduate, but I know that publicly discussing my complicated history with mental health—a conversation that should not be any more damning than talking about asthma or a heart condition—might prevent me from doing this. But that is exactly why I have to write this letter. It is time for us to reconcile with the reality of the world that we live in. It is time for me to say now what I should have told you before: You are not alone.

I should have told you about fifth grade, when I would stay up every single night thinking terrible thoughts. I had to make sure once, twice, three, four, five times that our doors and windows were locked, because I had to be sure. I had to know that no one would come in and slit my parents’ throats, and then beat my head in with a baseball bat.

I should have told you about sixth grade, when I touched flowers, and leaves, and people’s hair. My classmates did not understand, so they signed a petition asking me to stop. They gave it to the teacher, who presented it to me. Even today I remember the hurt and shame I felt when I saw the names of so many friends written on that piece of paper. They didn’t know that I could not help it; they did not know that it was outside of my control.

I should have told you about seventh grade, when germs consumed me. Bacteria crawled all over my body and inside my mouth. I would go to the bathroom repeatedly in the middle of class to frantically rinse my mouth and scrub my hands. When my best friend sneezed on me to see my reaction, and another spat in my juice and forced me to drink it, and another threw meat at me because she knew I was a vegetarian. I wondered if I had any friends at all. Maybe they were just pretending to like me because I was so funny to watch. I felt worthless; I felt hopeless; I felt powerless. I felt like I didn’t deserve to live.

But more important than any of that, Andy, I should have told you about how finally enough was enough. My mom got me help. She got me help, even when my teacher asked, “Why does he need therapy? He makes all A’s—he’ll be fine.” My mom replied, “I will be sure to write on his tombstone that he had all A’s after he kills himself because he hates his brain.” She knew what too few understand, that objective achievement means very little when life is nothing but shame and darkness.

Because of her intervention, I acquired tools to deal with my compulsions, to say “It Don’t Matter” until it really did not matter. Overcoming my compulsions was the hardest thing I’ve ever done, but it was worth it. I’m here today Andy, writing this letter to you, because my mom got me help.

Andy, I am sorry that I never told you about my middle school self. And I am sorry that I never told you how therapy empowered me to reclaim the beauty in life.

But I hope this letter to you will help change things for others. I hope it will convince someone who is like me all those years ago to find the support that they need. I hope it will encourage someone like me now—too busy with their midterms, their finals, and their papers—to check in on a friend. I hope it will encourage us as a community to fight against the stigma surrounding mental health issues both in our college and in our nation. And most of all, I am sorry that we live in a society where we could not talk openly to each other.

I miss you more than you can know, Andy. By relating this story—of what I did wrong with you, and what my mom did right with me—I want us to make a difference in the world. Then I will know that I am doing your memory proud.

Will

Originally published in the Harvard Crimson, September 2, 2015

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

In Reflection: Will’s thoughts on the process of writing and publishing this letter

At first, writing Dear Andy was pure catharsis. It was also extremely difficult. For years I had not been able to even talk about my history with mental health and the tragedies of my friends' suicides. To put my feelings into words for thousands of people to see would have been unthinkable to me. But after receiving support from my friends and my fraternity brothers, I found the voice to write my article. As a result of the attention that my article received, I am now working with a number of organizations on and off campus as well as Harvard administrators to improve mental health services. The feedback I have received since writing Dear Andy has inspired me to fight for mental health reform, both on campus and beyond. This has become my passion, and I am not going to give up until I have done everything in my power to change things.

William F. Morris IV is a member of the Harvard College Class of 2017 and is a joint concentrator in history and East Asian Studies.

Another Conversation with Robyn Houston-Bean, Founder and Director, The Sun Will Rise Foundation

By Val Walker

In our first interview, Robyn shared how the support from her grief counselor, her friends, and her support group had all helped to hold her through her darkest months after her son’s overdose.

Nearly a year after his death, she discovered that community action was her path to healing, and started her own support group in Braintree, MA. Soon she launched The Sun Will Rise Foundation. Her insights about how support groups and community service can empower us after a tragedy sparked a whole new conversation.

Val: Can you describe what gave you a sense of purpose a few months after Nick’s death?

Robyn: After a few months of grieving, I attended an event with a group called Hand Delivered Hope that does street outreach for those living with active addiction and who call the streets home. Joining in with other families and feeling so welcomed and accepted, it suddenly struck me that I had a sense of purpose: My child was not here anymore, but I could help another child. Although my Nick wasn’t here, someone else’s child needed my love and support. This warm, friendly group and others, such as Let It Out and The Boston Grief Group, inspired me and gave me strength to start my own group in Braintree. I knew we needed a grief support group closer to where I lived because I finally realized the scope of all this grief out there in the world. It’s so important that support groups are convenient for local people to meet and come together easily. We need people to understand us and validate our feelings, so we don’t have to make excuses for our tears and our laughter.

Val: I would love to learn more about how helping others is healing for you.

Robyn:  To put it simply, helping others helps me. I know that if I didn’t go down the path of helping others, I would be at a different place with my grief. Helping others forces me to step out of my own pain and hear and feel the grief of others. The group members are so appreciative to have a place to put their grief. Nick was so compassionate and caring, and each time someone is helped with our group, I know he is smiling down on me.

Val: It amazes me that you went straight to the Braintree Town Hall to ask about starting a support group. How did this happen?

Robyn: I knew a person who worked for the mayor, so I floated the idea of having a group at the town hall. Right away that person thought it was a great thing for our town to do. What a perfect way to say “no” to the stigma about the opioid crisis by having this group right at the Braintree Town Hall! After the group was going for a while, we had our first fundraiser for the foundation right there at the town hall. We have been lucky because not all communities have embraced the idea that substance use disorder can happen to anyone, and that we all need to work together to help prevent it.

Val: What was it like learning to be a group facilitator?

Robyn: I doubted myself very much at the beginning, but I received such great support from some of the facilitators. My doubts were erased very quickly. Figuring out the logistics, learning about facilitating, getting the word out so people in grief could find a tribe—all this kept my mind busy and kept me going in the early days.

Val: How is having a purpose contagious with other families affected by the opioid epidemic?

Robyn: I'm amazed how powerful it can be when people who are usually on the margins are given a voice. Grieving is hard enough, but on top of that, it’s a stigmatizing death, and it can cause people to focus inward and avoid dealing with day to day life.  It can cause grievers to be left alone in their grief by friends and a community that doesn't know how to deal with loss. Being part of our community, a place where people are safe to explore their feelings no matter what, a place where we can share anger, confusion, sadness, hopelessness, guilt and not be judged is a powerful thing. Having someone there to say, "Me too, I've felt that way" can really make a huge difference in our lives. Once you know you aren't alone, that there are hundreds of people out there who have felt your pain and have survived-- not only survived but lived again after loss--can be an incredibly healing realization.

Here are some ways that support groups have helped to turn grief into action:

• People build new friendships.

• They advocate for change in their own towns.

• They work to change laws.

• They gather together in prevention activities.

• They support the newest members of the group.

• They find their voice again.

I'm so glad the people who led the path before me gave me my voice, and that I have played some small part to help others find theirs.

Val: Robyn, you have been so generous with your passion and wisdom. Thanks so very much for all you have done.

Robyn: Thank you for giving me this opportunity to talk with the Health Story Collaborative.

Recommended Resources

• Robyn’s Foundation, The Sun Will Rise

• Team Sharing Inc., a national organization of parents who have lost children

• GRASP: Grief Recovery After a Substance Passing

• Hand Delivered Hope, Boston 

• The Opioid Project, created by Annie Brewster, MD, and artist, Nancy Marks

• Robyn Talking about Her Son, Nick, recorded on the Opioid Project

Val Walker, MS, is the author of The Art of Comforting: What to Say and Do for People in Distress (Penguin/Random House, 2010). Formerly a rehabilitation counselor for 20 years, she speaks, teaches and writes on how to offer comfort in times of loss, illness, and major life transitions. Her next book, 400 Friends and No One to Call: Breaking Through Isolation and Building Community will be released in March 2020 by Central Recovery Press.

Keep up with Val at www.HearteningResources.com

An Interview with Robyn Houston-Bean, Founder, The Sun Will Rise Foundation

By Val Walker

INTRODUCTION

Robyn Houston-Bean lives in Braintree, MA, and manages an insurance agency for four days a week. She is married to John Bean, a sheet metal worker, and has a daughter, Olivia, age 25, and a son, Jake, age 21. Amazingly, around her demanding business and the needs of her family, Robyn runs a dynamic, fast-growing organization, The Sun Will Rise, dedicated to serving families affected by the Opioid epidemic.

Three years ago, Robyn’s oldest son, Nick, died of an opioid overdose. Just one year after his death, finding a way to channel her grief, Robyn began building her foundation in honor of her son, and soon engaged hundreds of families with support groups, inspirational talks, and fundraising events.

I wanted to understand how Robyn was able to express her grief through community activism, and more deeply, to explore how she found comfort, understanding and support for her grief.

One grey morning in February, I enjoyed a rich, two-hour interview with Robyn. Her candid insights about how grief isolated her, and what it took to break through isolation and turn to others was a powerful story in itself. She didn’t hold back from “going there” to describe her first devasting weeks after Nick’s death. Her story is so compelling and important that I have written her interview in two parts. Part One is about how she broke out of the isolation of her grief. Part Two is about her healing adventure of developing her foundation, The Sun Will Rise.

Right at the beginning of my conversation, Robyn made one thing quite clear: We don’t ever “get over” nor completely recover from our child’s death, but hopefully, we learn to live with loss—and if possible, find a sense of purpose to guide our grief. For Robyn and many who support her work, community activism for facing the opioid epidemic has given devasted people a sense of meaning, purpose and belonging.

INTERVIEW

Part One: Breaking Through the Isolation of Grief

Robyn didn’t hold back from “going there” to describe her first devasting weeks after Nick’s death.

Val:  Can you describe the early stages of your grief—starting at the point you think it’s best to start?

Robyn: First, I should tell you about the night before he died.  I’ll never forget the night before Nick overdosed. Strangely, out of the blue, before Nick came home from work, my daughter, Olivia, said, “I have a bad feeling about him.” As soon as he got home, he walked straight to the fridge. When Nick put his face into the fridge I made him look at me because of my daughter’s feeling that something didn't seem right. I put both my hands on the sides of his face to make him look at me.

I asked, "Are you okay?" He told me, "I'm just tired-- I'm going to bed, why?" I answered, "Because I love you, and don't want anything to happen to you.”

He replied, "I love you too. I'm tired and going to bed. I have to be up for an early shift." It still haunts me that I didn't know something horrible was going to happen that night.

The next morning as I was headed out to the gym for my usual workout, I was surprised to see Nick’s car in the driveway, as he usually drove to work on the early shift. I wondered, why was Nick’s car still there? I called upstairs towards his room, “Hey Nick, are you up there?” It seemed so weird he was not answering as he was such an early morning kind of guy. I went to his room and found him lying motionless in his bed, cold and blue. I tried to revive him with Narcan but I could tell it was too late. I screamed a horrible, guttural sound—a sound I have never made in my life. Still, my daughter called 911. The EMT and police came and took him to the hospital, but he was gone.

Val: What a horrible shock—to be the one to find him dead right at home. Before his death, had there been any signs that you sensed Nick was using again or hiding anything?

Robyn: Not really. It was such a shock, and there really are no words to describe this kind of shock. He was doing so well and so proud of his new job as an Emergency Services Technician. He had just finished his certification and was feeling a real sense of purpose and mission in his life. He told me almost every day how he loved his work, and loved being so helpful for others, saving lives. But…perhaps, he saw too many awful things during emergencies and rescues, and maybe some things had triggered him. I will never really know.

Val: What were those first weeks or months like for you?

Robyn: Everything just stopped. I just stopped. All I could do was sit on the couch. I had always been a super-energetic person who loved fitness competitions and worked hard to be the best at anything I wanted to do. I was once the unstoppable, super-achieving woman who never looked back.

But when Nick died, I didn’t know how to be me anymore.

Unfortunately, my husband and youngest son didn’t know how to relate to this person I had become—this woman who just stopped everything. And my friends tried to text me and chat to cheer me up. But I couldn’t do chit chat anymore. My daughter could understand somewhat, but she was my daughter and was grieving in her own way. For me to grieve, I needed to have some of Nick’s things around me on the counter by the kitchen—his little harmonica, his coin collection, little pins he wore, his pocket knives, but this bothered my husband to the degree that this caused arguments. He didn’t want to talk about the death of our son or look at Nick’s stuff because he just wanted to push the memories away to get through the day. I was the total opposite from him in how I grieved. There was an awful tension between us. I felt lonely with my grief because no one in my family could understand how I was grieving as a mother. And I was anxious that my friends were trying to fix me and get me to socialize or get back to the gym. No one seemed to accept that the person I was before Nick’s death—that once unstoppable Robyn-- no longer existed.

Val: It sounds so isolating for you. No one in your family is the right person to talk to, and your friends don’t seem to understand how to relate anymore, even though they are trying. What in the world did you do?

Robyn: I had a gut feeling that a grief counselor might help me. For a referral, I asked a pediatrician I liked for years (who had treated my kids when they were younger.) He gave me the name of an excellent therapist, and fortunately I felt comfortable with her.  I opened up and shared everything with her. I was especially concerned about how to cope with my husband and children who weren’t grieving in the ways I was.  A few weeks later, I asked my husband and kids to join for family therapy. They weren’t too thrilled about it, but they cared enough to go for a few sessions. I was relieved this therapy resulted in finding a solution about how I could have Nick’s things around me without this upsetting my husband. We decided to put Nick’s little things in a box on the counter, so when I wanted to connect with Nick I could just get his things out of the box and then put them away. Believe it or not, this simple solution made a huge difference for me and my husband!

Val: Wow. I love what you just said. And what a perfect solution to use the box for Nick’s things.

Robyn: Eventually my daughter, Olivia, started going into the box, getting out his harmonica and coin collection, and sharing memories about Nick with me. But still…I had a long way to go to get used to my new normal without Nick in my life.  Indeed, we all had new normals without Nick in our lives.

But one day a thoughtful friend connected me on Facebook with a friend of his named Carole who had recently lost her child to an overdose. Very soon we were talking on the phone. We could “go there” with the horrible things that no one else could talk about. For our first face-to-face meeting, Carole met me at the cemetery where both of our kids were buried. Can you believe it—both of our kids were in the same cemetery lying near each other! We sat on the grass and cried together. We made a pact with each other that we would “take care of our kids” every day by going to the cemetery every day. We agreed that no one could rob us of our grief and the time we needed to “take care of our kids.”

Soon another friend connected me to other grieving parents through Facebook.  In a few months we found out about an organization called Hand Delivered Hope, a group of concerned citizens affected by the opioid epidemic. This group provided street outreach to people who have been impacted, meeting their basic needs so that recovery was possible. Hand Delivered Hope had organized a benefit event where participants were bringing bags of comfort items. My sister and I attended this event, and to my surprise, I made friends easily with other parents and family members who had lost loved ones or had loved ones still struggling. I didn’t feel judged or that I had to censor myself from talking about messy and awful topics related to addiction. They busted through the stigma of addiction as I was accepted and welcomed. They asked about Nick, and how I was coping with my grief. They shared their own stories about broken relationships and how their kids were destitute, misguided, broken, or had died through an overdose. It was a safe place to talk honestly as a group, and I immediately realized how healing it was to have this open, warm environment where I could be a grieving mother—rather than trying to be that unstoppable, super-achiever person I used to be. This experience of feeling so welcome with my grief was a big turning point for me.

I had a huge revelation, and it all came down to this: My child was not here anymore, but I could help someone else’s child. And I could help someone else who was grieving to feel warmth and acceptance. Braintree needed more support groups, fundraising events, educational events, and resource development. Soon after my revelation, one thing led to another. I met another wonderful friend named Rhonda who was involved with a grief support group at GRASP in Brighton. She told me there was no grief support group on the south shore of Massachusetts. And things started moving from there—it was my calling. I believed I was the one to do this.

Val: Thankfully, you found a group where you didn’t have to hide your grief, and that inspired you to start your own support groups. What about your older friends? Did they fade away? Or were you able to maintain those friendships alongside the new friends you were making?

Robyn:  Yes, I have been able to keep most of my old friends. I finally managed to figure out how I can fit my old and new friends in my life. First of all, these two groups of friends are two separate groups. I call my old friends my “before” friends (before Nick’s death) and my new friends my “after” friends. The “after” friends definitely “get me” more easily and I can talk about the good, the bad and ugly stuff with them. However, I truly love my old friends and I tend to do more fun and lively stuff with them—which is just fine for short periods. I don’t want to be a “downer” with my “before” friends. My “before” friends still want to see me laugh and socialize, and I’m able to do that on some occasions. I must admit they can still make me laugh. I am glad to have both groups in my life. But I couldn’t live without my “after” friends.

Val:   Robyn, what a creative way to make room for all your friends in your life. That also sounds like a beautiful way to embrace your “before” self with your “after” self.

Robyn: Thank you for saying that. It’s all taken a long time.

This concludes Part One of my conversation with Robyn. In my next post on the Health Story Collaborative, Robyn will share her healing journey with developing The Sun Will Rise Foundation. 

• Recommended Resources

• Robyn’s Foundation, The Sun Will Rise

• Team Sharing Inc., a national organization of parents who have lost children

• GRASP: Grief Recovery After a Substance Passing

• Hand Delivered Hope, Boston 

• The Opioid Project, created by Annie Brewster, MD, and artist, Nancy Marks

• Robyn Talking about Her Son, Nick, recorded on the Opioid Project

Val Walker, MS, is the author of The Art of Comforting: What to Say and Do for People in Distress (Penguin/Random House, 2010). Formerly a rehabilitation counselor for 20 years, she speaks, teaches and writes on how to offer comfort in times of loss, illness, and major life transitions. Her next book, 400 Friends and No One to Call: Breaking Through Isolation and Building Community will be released in March 2020 by Central Recovery Press.

Keep up with Val at www.HearteningResources.com

When a heavy object falls on one’s foot, it exerts pressure on the skin and muscles, and that hurts. Raw sensation is the pressure, and everything beyond that is interpretation. To feel is a combination of raw sensation and interpretation from the brain based on past experiences.

But when one loses the ability to recall, one loses the ability to interpret and sometimes even the ability to feel.

My grandmother’s gradual decline all started over a decade ago, in the Malagasy province of Morondava, in Madagascar. My father remembers the day when everything radically pivoted and his world turned upside down: after a strenuous day of housework, my grandmother —for just a moment — confused day and night.

A few years later, the diagnosis was given: Alzheimer’s disease, coupled with brain aging and a strong 25-year-old depression. My grandmother moved to the capital city of Madagascar to become the sixth resident of our household. My parents, sisters and I shaped our lives and schedules according to what we thought my grandmother would feel most comfortable with. She was the beloved center of our lives.

Within several years, all my grandmother could remember clearly was her name. It seemed as if she had entered a parallel universe she had created herself. She got lost in her thoughts while tracing flower patterns with her feet and counting the number of lights out loud. There was no way of telling what she was thinking. I could not bare thinking about how often she felt lost, alone, or misunderstood. The thought haunted me for days; it made me feel utterly helpless.

As her amnesia worsened and her brain activity declined, my grandmother stopped interpreting raw sensation, and, slowly lost her reflexes. She sometimes forgot to drink water after putting a pill in her mouth, and chewed on the medicine instead. The bitter taste surely made its way through the taste buds on the back of her tongue, and was probably sent to her central nervous system, but somehow was not interpreted. Not a single cringe showed on her face.

One may say that her inability to interpret sensation caused her to stop feeling. Indeed, not once did my grandmother show signs of anger, sadness, or even slight feelings of impatience. But she often laughed. Each time she disappeared into her parallel world, I witnessed genuine happiness.

Some people believe that acts of kindness and empathy do not make a difference in a world in which man has already reached the moon. But I believe that it is the little steps we make that end up being the most precious ones. Offering to share her popcorn while watching cartoons on TV made my grandmother happy. When I simply asked about her day, or commented on the flowers that grew in the garden, a smile appeared on her face.

As I grew older, I understood the importance of empathizing with my grandmother. And how could I possibly attempt to do so without her collaboration? I could not change the way she perceived her world, but I could change the way I perceived her world: it all had to do with acceptance.

Empathy, I feel, is the ultimate solution to alleviate one’s pain and help someone make peace with their condition. Within empathy lies acceptance. Coming to terms with a condition is the first step towards wellness. My grandmother was not part of the world I knew so well — this was a fact I could not argue against. There was no use in me trying to include her in the present by constantly reminding her of the time of day or the year, trying to bring her back into my reality only confused her.

In the last years before my grandmother passed away, my family and I ceased trying to heal her by forcing her to remember. We let her imagination go free, and even took part in her adventures. Her imagination, stimulated by compassion and attention, helped her recall certain pleasures of places, smells, sights, tastes, and faces from her past. This seemed to allow her to reconnect with small part of her old self, and make her feel more comfortable in her daily life. I am eternally grateful for all I learned from my grandmother. Her story taught me the immense powers of compassion.

Heena Nissaraly is a sophomore at Boston College majoring in Nursing and minoring in Medical Humanities. She aims to become an empathic nurse specialized in anesthesia or hospice care, and hopes to eventually improve healthcare in Madagascar.

My younger brother, Simon, will always be my best friend. He was born with a mitochondrial disease and was never able to speak or walk, yet he exuded kindness through his unique and loving personality. Simon's gratitude radiated during each of his days, no matter how tough. He often needed nebulizer treatments and suctioning to aid his breathing, but he flashed us huge grins despite the discomfort of the mask and tube, as if we were all in on the same joke. He truly loved and appreciated the things that many of us take for granted, like taking long naps, getting off the bus after a day spent at his special education school, going to music class, and spending a sunny afternoon sitting outside. He especially loved spending his birthday with family, friends, and colorful balloons tied to his wheelchair. I will always remember the huge smile he had whenever he caught a glimpse of the Perry the Platypus balloon I gave him for his twelfth birthday, which somehow remained inflated for months.

Several months after his twelfth birthday, Simon’s respiratory problems became severe. We learned that he likely had less than six months to live. This news was difficult for me to handle as a sixteen-year-old, but my parents and friends offered immense support. My best friend often escorted me out of the classroom when I needed to cry, and my mom frequently picked me up early from school and took me to our favorite coffee shop. In November, Simon began a hospice program and continued to enjoy each day through massage therapy, music, his teachers and caregivers, and our family.

On March 26th, less than three weeks after Simon’s thirteenth birthday, I received the call from my parents that I had been dreading. They told me that they raced home after an urgent call from his caregiver. He was having more trouble breathing than they had ever seen, and they weren't sure how much time we had left with him. Since he had survived many rough days in the past, I clung to the hope that when I got home he would still be smiling at his orange thirteenth birthday balloons.

My mom stopped me at the door on my way inside the house. She told me Simon had passed away a few minutes prior. My vision blurred and I dropped my backpack. I ran into my parents’ room where Simon lay, still believing that he would be okay. Once I physically reached his body and could no longer hope for another day with him, it felt like my whole life shattered. I hugged him, crying, and wondered how we would continue on without our favorite ray of sunshine.

While losing Simon was unbelievably traumatic and devastating, it motivated me to spend time with other children and adults with special needs. Two summers after Simon’s passing, I worked as an assistant teacher at his special education school and as a respite caregiver for people of all ages with disabilities. I am grateful to have had the ongoing opportunity to work with individuals with exceptional needs and to teach and learn from them. My experiences with Simon and other members of the special needs community with whom I connected have inspired me to work toward a career in medicine. I plan to dedicate my life to offering care and love to children with disabilities.

Isabel is a junior at Vanderbilt University majoring in Medicine, Health, and Society. She grew up in Michigan but currently lives in Boise, Idaho with her Great Dane, Arthur.

Tiron, Marie’s husband shares his perspective.

In 2010, Kate, a single mom from New Hampshire, gave birth to Brook, a healthy baby girl.

Brook seemed to be developing normally and reaching all of her milestones — learning how to sit up and roll over, grasping at toys–until she was 6 months of age, at which point she started to regress. She lost skills she had already learned, and gradually, Kate noticed other things. Brook didn’t seem to respond to her name, she would fixate on lights and just stare and stare, she started dropping toys, unable to hold onto them. Eventually, after a long medical work up, Brook was diagnosed with Tay Sachs disease in 2012, and Kate was told that her daughter would most likely not live past her fourth birthday.

Today, Brook, is three years old and requires constant care. She is blind. She cannot swallow and is fed through a feeding tube. She is having near constant seizures. And she continues to deteriorate. Brook’s older brother Jake, born to a different father and now 9 years old does not suffer from the disorder.

Listen above to Kate’s story of living with and caring for her terminally ill daughter.

Tay Sachs is a fatal genetic disorder. A child is born with Tay Sachs when he or she inherits two damaged copies of the HEXA gene on chromosome 15 (one from each parent), which results in a deficiency of the Hexosaminidase A enzyme and the subsequent build up of a damaging fatty substance in brain cells. The result is a relentess, progressive loss of physical and mental functioning and eventually, death.  A person with one damaged gene and one normal gene will become a carrier with no clinical symptoms of the disease. If two carriers have children together, there is a 25% chance of giving birth to an affected child with each pregnancy.

Tay Sachs, a rare disease with an incidence of approximately 1 in 320,000 in the general population, occurs with increased frequency in certain populations, including Ashkenazi Jews, French Canadians, and Cajuns (from Louisiana). In these groups, approximately 1 in 30 individuals is a carrier, and 1 in 3,500 children will be born with the disease.

Kate, who is of French Canadian descent, had no idea she was a carrier before Brook’s diagnosis. She knew nothing about Tay Sachs, and was unaware that French Canadians are at increased risk. Though pre-conception counseling is available, Kate didn’t know this at the time, and if she had, she might have assumed that it wasn’t relevant to her.

How does a mother manage life when her child is dying? She mothers. Kate spends most of every day in her living room with Brook, an oxygen machine hissing in the background, surrounded by pill bottles, suctioning her daughter’s secretions, moistening her lips, and giving her medication to temper her seizures. Kate’s primary goal is to keep Brook as comfortable as possible in her last days, and she works very hard to achieve this. “So many people for so long would say, ‘You’re so amazing, I don’t know how you do this; This is incredible, how do you manage this,’” Kate says “I would look at them and think, ‘This is my daughter, how can I not do this?’” And every day she tries to spend as much time as possible with her older son, Jake, and to support him through the loss of his sister the best she can.

Story first appeared on WBUR’s CommonHealth blog on November 8, 2013: http://commonhealth.wbur.org/2013/11/extreme-mothering-child-tay-sachs

Photograph: Mary White photography

Resources:

http://www.mayoclinic.org/tay-sachs-disease/treatment.html

http://www.ntsad.org/

Spring 1997

I eye up the worn and tattered catcher’s mitt 20 feet ahead. It’s a warm May morning and the elementary school bus is coming down the street in 10 minutes. But, more importantly, baseball season is finally here. Mom is down in the catcher’s stance, “Fire it in here!” she shouts and then grins at me as I start my wind up. I pull my gloved hand up to my face and tuck my right hand in, resting the ball in the heel of the glove. I take a short step to my right and shift my weight slightly over my right foot. I swing my left leg up high and, pushing off my right leg, send everything I’ve got into the pitch, whipping the ball at mom, as she squats in the grass with the mitt held open wide. The ball smacks into the glove’s weathered pocket with a “Crack!” “Isn’t that the best sound, And!?” she exclaims, firing the ball back to me and readying herself again. We have to get 10 pitches in before the bus comes. There is no secret to being good at something. You just have to love to practice. That is her philosophy. Now it is mine too.

January 2011

It’s now junior year of college and my morning routine has shifted away from baseball. Now I get up, eat oatmeal, and review notes before class. Fewer “heaters”, a lot more books, but the same philosophy: love to practice, love to learn. I write frequently in the journal I keep on my computer. So far it is mostly ramblings -- on my dying faith in the Catholic church (what’s the point of God?), on my breakup with my high school girlfriend (what’s the point of love?), on my fascination with cell biology and chemistry (what’s the point of studying anything else but the pure molecular basics of life itself!?)

In this moment, my relationship with cancer is so ordered and neat and sterile. It is a series of PowerPoint presentations in air-conditioned classrooms. A set of logical experiments, producing clear data from which succinct conclusions are drawn. It is graphs and figures and tables and genes and proteins and signaling pathways. I have a poster outlining all the known cellular pathways that contribute to cancer on the wall beside my bed. Cancer biology is what I do, not something I fear.

April 2011

That ordered, neat, sterile, intellectual relationship with cancer collided with the powerful, unpredictable, emotional, force of real life on a beautiful spring morning later that semester.

I am home for the weekend from school, with my mom. Our morning ritual is to have a cup of Irish breakfast tea together. Always with a splash of evaporated milk and a half teaspoon of honey. We started this in high school when she was teaching 9th grade and I would hop a ride to school with her each morning.

I made my cup and walked out to the back porch where she was sitting, her mug beside her, at our small wrought iron table. If that table could talk, it could tell the entire history of our family. It has sat on the cracked slab of concrete we call the back porch ever since we moved in on Evelina Road

“Good morning, Andrew” my mom says as she smiles and looks up at me from the crossword puzzle, looking not quite her usual chipper, enthusiastic self.

 I don’t remember exactly what we talked about at first, but, eventually, she said to me, “I’ve got some news, And. I went to get this thing on my leg checked out and they said I’ve got some bad cells.”

 To me, immersed in a Cancer Biology class, bad cells equal cancer. No need for further description. I just took an exam on this very topic.  How ironic is that? “Bad cells” stop doing their jobs. “Bad cells” disobey orders. “Bad cells” exhibit the 6 characteristics of cancer, which I can hardly remember in this moment.

“What did the path report say?” I ask. “What kind of cells? How fast are they replicating? What stage is it?” In this moment of internal turmoil, I grasp for what is familiar to me – the science and the cells -- rather than looking for what might be helpful for my mom. She recognizes my angst and -- despite the fact that she received the diagnosis, she will receive the treatment, she will be confronted with  her own mortality in the coming weeks-- she opens her heart and comforts me.

June 2011

You would never find mom inside on a sunny day. She’d be ticking off miles walking all over town with her best friend, hitting the tennis ball with a fellow teacher, or kneeling in the garden behind the house, back bent, hands covered in mud, transplanting some black-eyed Susan’s or pulling weeds. But on this “glorious summer day”, as she would most certainly have proclaimed it, there she was, inside. She was curled up with blankets in her bed, her hair, frizzled and wild, pushing out over the covers. She was now a few weeks into interferon treatment for her cancer. On the days of her infusions, she collapses into bed with chills and whole body aches. It’s jarring seeing my mom so visibly weak. She could not help the shivering. She could not bite her lip and just power through the aches. The interferon was pummeling her and I hated the medicine for doing that, even though I knew, theoretically, that it was helping. I went into the room and wrapped my arms around her without anything to say.

Eventually she completed the treatment and the chills and the aches stopped. The scans came back “clean”; but that might have been the easy part: getting cancer off the scans. The real hard part is getting it off your mind. Mom told me that the greatest challenge after treatment is not becoming obsessed that every headache or cold, sharp pain or little rash is a sign that the cancer is back.

For the rest of us, at least superficially, things seemed to be “normal” again. We didn’t really talk about cancer. We didn’t use the term “remission”. We just assumed “cured.”  It was logical. Plain and simple. Mom had cancer. Mom endured the treatment. Mom beat it. Like we knew she would. We could all move ahead with our lives now, thank you very much.

April 2015

Until last spring, April 2015. She went in for her yearly PET scan. She came back with “findings” that needed to be explored with a biopsy. “This really is not happening,” I remember thinking to myself, “Why not?” came an internal reply.  The worst was confirmed: metastatic melanoma, stage IV cancer (“That’s the last stage,” I remember telling my older brother when he asked me how many stages there are).

September 2015

Now I’m in the first year of medical school. Tomorrow we will be talking about melanoma in class. I am doing the reading to prepare and I come across the survival statistics. Odd that I have never actually looked this up myself before. The five-year survival rate for a person with stage IV lung metastases is 17%. I stare at the accompanying figure, a Kaplan-Meier survival curve. Looking out at the 16-month marker on the x-axis: not many survivors. Were all those dots on the chart really someone’s mom or dad, or brother or sister? I keep reading, “Malignant melanoma is the cutaneous neoplasia with the greatest mortality rates and one of the malignancies with the highest potential of dissemination. The prognosis of patients with metastatic melanoma is grim…” Time for a shower, I think,. Enough studying for tonight. I walk down the hall of our dorm in my sandals, head straight to the showers and turn the water on hot. I get in and stand there for a few moments, letting the water pour over me. “The prognosis is grim,” I think to myself, “17% survival at 5 years.” “Shit,” I whisper. I am hit with this longing to see my parents and be with my brothers. I picture my mom’s funeral. My brothers carrying the casket. I picture my dad speaking at the wake, thanking everyone for coming. There’s my mom’s sister and brother. There’s her best friend. There are her nephews waving goodbye to her. I picture my mom on the back porch with a cup of tea, looking toward the sun. The hot water runs over me and I weep. I cover my face, but what is the point? I can’t stop it; the tears flow, falling off my face, joining the water droplets from the shower, crashing into the tile and falling down the drain. I want to follow them down there.

September 2016

I pull a mask over my face, slip a pair of gloves on while I make my way over to the metal table to join my classmates, who are peering over specimens while a pathology resident asks a question: “What do you guys think this person died of?” I pick up the cold tissue in my hands. Definitely a lung, though it is collapsed now, greyish-tan color – bland, lifeless. The tissue is dotted by small dark specks, some as small as a pencil’s tip, others the size of its eraser. I roll these little specks through my fingers. They are smooth, but irregularly shaped. They are hard and stick well to the tissue. They are uniformly black. “Is that from smoking?” a classmate ventures. “No, but good guess!” the resident replies excitedly, “That black stuff isn’t from particulate matter. Think about what cells can make that sort of pigment.” Another student speaks up, “Skin cells. Melanocytes produce pigment!” The resident, who nods in approval, concludes, “Yes, this patient died from metastatic melanoma.” The group shuffles to the adjacent table where diseased kidneys await us. I stand with the melanoma lung in my hands and roll my fingers over the small bumps again and again.

As a medical student, I’ve learned enough to fear diseases like cancer, by studying their pathology, watching tumors excised from abdomens in the operating room, or as I did recently, holding the nodules of metastatic melanoma in my hands.

But as a son, the disease is not so much what I’m afraid of…loss is. The cellular morphology isn’t scary. Even the scans aren’t that scary. The thought of being without someone irreplaceable, like my mom, is what is terrifying.

Sometimes I try to live only as the medical student, sometimes only as a son. This experience, I’m learning requires both, and, as a great poet has said, the only way forward it seems, is to live like the river flows, carried by the surprise of its own unfolding.*

* John O’Donohue

Read more from Medical Student Voices here

Learn more about the Community Voices and discover more empowering health stories here

Andrew is a second year medical student at Harvard Medical School.

Ana Bess Moyer Bell

Drama Therapist, Founder of COAAST (Creating Outreach about Addiction Support Together)

By Val Walker

Ana Bess Moyer Bell is the founder of COAAST, a non-profit organization in Rhode Island that offers arts-based education and therapeutic programing to address the opioid epidemic, aid in prevention education for teens, and continuing medical education for healthcare professionals. She most recently graduated from New York University with a Masters in Drama Therapy. She currently works as a Drama Therapy consultant for The BETES Organization creating and implementing theater-based programs for families of children diagnosed with Type 1 Diabetes. She previously worked as a drama therapist at Access Community Health Center, an outpatient substance abuse clinic, in Manhattan, New York. She held a position as drama therapist at the VA Hospital in West Haven Connecticut, and worked with patients in hospice, cancer treatment, and with PTSD diagnoses. From 2013-2014 she volunteered in San Quentin Prison where she co-facilitated group talk therapy with inmates.

COAAST is a non-profit 501(c)(3) whose mission is to create an ongoing dialogue about addiction and recovery through arts-based community-engaged programming. COAAST (Creating Outreach about Addiction Support Together) is a community-oriented organization that helps individuals recognize addiction not only affects the addicted person, but also their family. Their programs use this saying as a guide: “We hurt in relationship, therefore we heal in relationship.”

Val: What sparked your interest in doing theater about the opioid epidemic?

Ana Bess: I lost my high school sweetheart to an overdose in 2012, which I thought to be an isolated incident. By 2014, three more of my friends died from addiction. I was suffering from the grief of so much loss along with many others around me. There was a feeling of isolation inside this kind of grief because heroin addiction is stigmatized, and often there are feelings of deep shame. From my own suffering I understood that addiction is a family disease, as well as a community disease.

2014 was the turning point when I realized something bigger was happening—more overdoses were reported that year in New England, the worst ever. Communities were desperate. We needed to share our experiences in a way that brought families, friends and communities together. Because I knew theater could be a safe place to explore our stories together, I believed the timing was right to start a theater project about this crisis.

As soon as I became openly vocal about it on Facebook, it seemed like people came out of the woodwork to tell me their story. I inadvertently became the town’s story collector. From these stories themes began to arise; shame, silence, guilt, scapegoating, loss…etc. Finally, I sat down and teased out all the salient themes, and used them to write the play, Four Legs to Stand On.

Val: How does theater create a safe place for healing?

Ana Bess: Theater does two opposing things, both at the same time:  It brings you in so you can empathize with the characters, but it also provides distance, so you see their situation in a larger perspective. Sitting in the audience with the physical distance of the stage, we can be deeply touched while gaining a greater perspective all at once. This happens simultaneously, so we’re participating in an event in real time, while reflecting on it.  Theater asks a lot of us as participants, both in the audience and on stage.

Val: You say theater asks a lot of us as participants, to feel and react, but also to see the bigger picture more clearly at the same time. When it comes to the topic of the opioid epidemic, what is it about a performance that heals the grief and suffering?

Ana Bess: First, just acknowledging people are suffering from being stigmatized, and suffering alone. This very act of acknowledgment connects us. As the story unfolds on stage, we see how this epidemic has separated and divided us, and how we are isolated in our suffering.

Val:  It’s ironic-- by acknowledging the aloneness of our grief together in a theater, we become connected.

Ana Bess: Yes, and by witnessing our own stories, we become more compassionate and empathetic with ourselves. We must start with ourselves. Even subconsciously, we feel a call to action within ourselves.

When we go to see a performance we create a supportive community, at least for a brief period in time. This is especially important for people struggling with addiction. Research has shown they are more likely to seek help, enter rehab, and follow through with long-term recovery when they have a supportive community and family.

After each of our performances we always provide a 20-30 minute period for the actors to take questions from the audience. Talking together following the performance is a vital part of healing. This offers the audiences a space to process their feelings, tell their own story, and brainstorm what their immediate community can do in terms of social action. We often perform for medical communities, such as Harvard medical staff, the Rhode Island Department of Health, and other healthcare entities.  CEUs and CMEs can be provided.

Val: I’ve read terrific reviews of your play, Four Legs to Stand On, which toured this fall throughout Massachusetts. Can you tell us more about this year’s highlights with your group, COAAST?

Ana Bess: Where do I begin? What all of us as a cast sat with over and over again this fall was the overwhelming amount of loss. Town after town, we were faced with mothers, daughters, uncles, friends, and lovers of those lost to opioid addiction. When we were in Middleborough, there was a mother in the audience whose son had died five days prior to us performing, and I’m not exaggerating in saying that every single person in that sold-out crowd had lost someone to addiction. The devastation this epidemic has caused was so palpable every place we performed, and yet felt so silenced.

I learned again the dire need for better and more accessible treatment. Again, over and over, it was glaringly clear how important family and community support is; not only for our addicted ones, but also for those who love them.

At our final performance at a gorgeous black box theater in Franklin, one of the audience members pointed to a lack of attendance. If this were another more fashionable disease, he stated, the room would be filled with a line out the door. So, I guess that’s what I’m left with: stigma is still our biggest battle.

Val: Where will you be performing in 2017? What lies ahead?

Ana Bess: I will be using the performance to teach at some Universities this winter, and we have begun booking already for our spring tour. You can find those dates on our website: www.coaast.org. If you are interested in bringing us to your local community theater, hospital, or school, please contact us.

Val: If you could sum up why storytelling through theater is vital for you, what would you say?

Ana Bess: I believe in the power of storytelling; it is how we make meaning of our lives. Story is a meaning-making tool. Through performing, sharing and witnessing our stories, we’re able to uncover what it means to be a human being. It helps us feel less alone, less disconnected, and more understood.

Val: This is such important work you are doing. I’m honored and thankful to have spent some time with you today.

Ana Bess: Thank you. I’ve enjoyed it.

Ana Bess Moyer suggests these websites for further reading about COAAST and the opioid crisis.

LEARN TO COPE, a support network for families coping with addiction and recovery

SUBSTANCE ABUSE AND MENTAL HEALTH ADMINISTRATION

FACING ADDICTION

SAFE COALITION

AED FOUNDATION, ASSIST, EDUCATE, DEFEAT

Val Walker, MS, is the author of The Art of Comforting: What to Say and Do for People in Distress (Penguin/Random House, 2010). Formerly a rehabilitation counselor for 20 years, she speaks, teaches and writes on how to offer comfort in times of loss, illness, and major life transitions. Her next book, 400 Friends and No One to Call: Breaking Through Isolation and Building Community will be released in March 2020 by Central Recovery Press.

Keep up with Val at www.HearteningResources.com

Today I attended the funeral of my friend and neighbor of 35 years, Ms. Enid.

No one knew her exact age except for her best friend Ruby, another neighbor here at the Roycroft, our six-storey art deco apartment building that we all lived in.

Enid was distinguished and healthy, but dementia grabbed her sensibilities in her last year. Because she was single and had no family, she was sent to a nursing home far away from the Roycroft and her friends, a good forty-minutes drive on the highway.

Her death has had a huge impact on me. I miss her tremendously, of course, and her passing has made me reflect upon my own situation. You see, I’m single too. Even though I have my will in place and am relatively healthy (despite the Canadian health system), financially stable, and of sound mind and soul, I’m not sure that my end-of-life wishes will be carried out. Who will be my advocate?

I’ve selected two executors, but in reality, in the absence of caring family or friends, I worry that no one monitors the executor. What happens if there’s no one left alive to watch over you and your belongings? Can the executor do anything he/she pleases with their client’s estate, body, burial, and belongings? It seems the courts only step in if someone blows the whistle.

Enid’s funeral service seemed designed more to please the needs of her estate lawyer than to please her. When I asked him where Enid wanted to be buried, he admitted that he had never asked her. Her ashes were to be shipped two hours away to a cemetery where he believed her parents are buried. I asked him if Enid wanted to be buried with her parents. He said he hadn’t asked her. How could that happen, I thought?

Interestingly, Enid did have the wherewithal to state that her obituary NOT print her age. Good for you, Enid. Age should be irrelevant, and besides, it’s no one’s business.

These days when we hear a person’s age, assumptions form. An older person is rarely thought of as being or having ever been vital, skilled or talented, and yet, many were and are. While other cultures honor and respect their elderly population, North America seems to dismiss the thought that a senior can be captivating, attractive and interesting. Adding insult to injury, seniors are often referred to as ‘cute’. A puppy is cute. A baby is cute (sometimes).

Unfortunately, after a certain age, people become a member of the invisible race. (I should keep that in mind the next time I want to steal something.)

Enid's memorial service was different than those I’ve been to, particularly because she had no living relatives, no one to eulogize her life from personal experience, and no one to shed tears the way primary mourners do. I cried plenty when I received the news of her death, but somehow that's not the same thing. Or is it? Enid’s friends didn’t want to speak at her service, so I was asked to say something.

I spoke about being Enid’s neighbor for over three decades and what she meant to me. I spoke about the night we spent together one New Year’s Eve, sharing stories while she polished her late mother's silverware, an annual ritual. I spoke about the answer she gave me when asked how she maintained such a close friendship with Ruby for over 60 years.

“Two things, Marla…boundaries and privacy.”

And I spoke about the best advice she ever gave me: “Take a walk every day, and have a goal for your destination. It could be to buy an apple, or the newspaper. Most importantly Marla, get out and move.”

As I looked out into the faces of Enid’s few mourners--just eleven neighbors from The Roycroft, her cleaning lady, and our superintendent--I thought about the sense of community we had created, complete with love, hate, and disparity.

When Enid’s memorial concluded and we crowded around her boxed ashes, and fragile-framed portrait, her lawyer asked a painful question:

“Does anyone want Enid’s photographs?”

Enid's photographs were respectfully scattered about the memorial room as if it was a staged set. We didn’t know who the people in the photos were or their importance to Enid. But there they sat, and what to do with them now was our dilemma. These photos may have been of her parents, or treasured aunts and cousins. We shall never know, now. What we did know was that no one wanted them, not even Ruby (who is also single with no family and 95 years young). Perhaps for Ruby it is just too painful a reminder of what she will miss. I wonder how long she will last without Enid, her best friend, to walk with and talk with and share meals with, especially on Christmas Eve and New Year’s Day.

An 8x10” portrait of a younger Enid now sits in our lobby, with a battery-operated votive candle beside it. Soon it will be removed, tossed into the trash and driven to the city dump where it too, will become ashes.

Questions swirl around in my mind.

Is this how the single population in our society end up? Our once cherished photographs recording our life, loves and lineage all to be tossed into the garbage?

What becomes of their worth, their knowledge, and their very existence?

Deep in my heart, I know that my photos, articles, and recordings of my careers will also end up in the city dump along with the other single people’s tangible memories. They are nobody’s keepsakes but mine.

For now, I’m going to dust off my framed articles of me as standup comic, inspirational speaker, and jazz singer, as well as my photo collection of family members and dogs. I’ll try not to think about what will become of them when I am gone.

A common epitaph is: “You Will Live in Our Hearts Forever.” Another popular one is “Gone, but not forgotten.” I’m starting a new one: “Ashes to Ash, Tossed in the Trash.”

I’ve learned a lot from Enid’s death. We must all legally prepare for our inevitable passing, and get our specific needs, desires and end-of-life arrangements down on paper, while we are mentally able to do so. And we should have someone outside of the executor’s circle making sure our wishes are respected. Some find it morbid to discuss such matters. The truth is, it’s imperative. I’m feeling a bit low today and I know what Enid would tell me. She’d say “Marla, go for a walk. Pick a goal for your destination. Buy an apple, a newspaper, it really doesn’t matter what. Just get moving. It will make you feel better.”

I think she’s right.

Marla Lukofsky is an Inspirational Speaker, Comedian, Singer, Cancer Survivor and Writer. Her stories have been published in various medical journals including Cell2Soul. With two TEDx Talks to her credit, Marla continues to share her experiences in the hopes of helping others.

When I was five, I wouldn’t let a single person near my hair. My mother had to go out and buy me an expensive bristle brush designed for sensitive scalps. She gave me a peek at it in the car as we drove home. “It’s a magic brush,” she told me. “A magitch brush,” my dad would correct with a wink.

 Still, hair-brushing time always filled me with dread. In a sudden burst of toddler witticism, I compared the process to airplanes flying into the back of my head. My mother and my nanny Marcy had to get creative. In a particularly successful method, I would wrap my arms around the hairbrusher in question and holler into her shirt as she teased out the snarls. In another approach, I would flip my head upside down and stand with the blood rushing to the tips of my ears as my tangles were torn apart. My dad lacked the courage to even try. On the mornings he was in charge of my hair, he spent half an hour gingerly skimming the brush somewhere over my head, leaving a knot hidden at the nape of my neck.

 My mother lost her hair twice. Every morning, she would wake up to another nest on her pillow, her hope to be spared shattered like broken eggshells. I was too young to grasp the gravity of this grief. I wrote her a poem as a peace offering, and then cut off my own hair to my shoulders three times. And while she fretted over her scarves, I admired them. She picked the most beautiful colors: blue with white-lined diamonds, swirls of autumn painted with the browns and reds of dying leaves, lilac stained with deep purples.

 When her hair grew back the first time, it arrived in curls. My mother taught herself to tame it with her hair dryer and various brushes, the scariest of which I dubbed the Red Brush. On weekday mornings in the winter, I would wake up to a pitch black sky and the distant croak of crows. I’d burrow under my blankets, listening to the sound of running water from down the hall. The house was dark but for the soft light from the bathroom, and it was a comfort knowing someone else was up, that she would soon raise the heat, flick on the lights, and sing me awake. It was a comfort knowing that my mother was standing in front of the steamy mirror, wrapped in a towel and curling her bangs, playing with her hair until cancer skulked away, defeated.

 I taught myself to braid after she died. She had showed me the basics – three pieces, weave under, over, under again – but I had never mastered it on my own. Even ponytails were beyond my ability. I spent ages in front of the mirror each morning, screaming in frustration. I worked at it until my scalp groaned in pain. Caring about the inconsequential was my means of survival. But now when I pull at my hair, I don’t worry about it being perfect. Instead, I remember the way my mother twirled her finger around the wisps of my hair when she told me that she loved the way they curled.

 On those mornings when we were running late and my hair was in no state to make its daily appearance, my mother would wash it in the kitchen sink. She’d rest a towel behind my neck and tell me to lean back, the tips of my hair dangling near the drain. I can still feel her fingers on my head as they traced rhythmic circles from one side to the other. I can still hear the squeak of air as she squeezed the shampoo bottle and made fireworks of soap bubbles float around us.

Anna McLoud Gibbs is a freshman at Harvard College. She has not yet declared a major. She is from Ipswich, Massachusetts.

It was quiet that afternoon. Weekday afternoons were always quiet in our house. Dreamy, lazy, languid in the heat of summer, resting on the downstairs couch I heard you calling me from upstairs. Your voice had that same timber, will always have that same timber every time you call me upstairs. I rose, hesitant to leave that sunlit couch, but your voice again Claire, come up just a moment! there again beckoned me up, up into that bathroom. I entered the room and met eyes with you and you said I just need your help for a moment in that hushed way, in that way that made me know it was ME who needed to help you, and it couldn’t be Jill. That hushed language between parents and older siblings is one you learn from the moment that second child is born. Out on the smooth counter-top sat Dad’s old electric razor. I lifted it, felt it weigh in my hands. I knew what was coming, God we all knew it was coming. It had been coming since April, since that hushed conversation, that same hushed language in the car on a same sunny afternoon, that same don’t tell Jill had weighed the same as this razor weighed now. You sat in that chair and stared back at me from the mirror, but your eyes weren’t meeting mine, not really, and mine weren’t meeting yours, not really.

You looked like a child then, like I did when I was five and waiting for Dad to comb my hair, and you looked up at me, your child, in that same way. Waiting for me to comb your hair. The razor felt heavier now, the weight of that hush felt heavier now, everything was heavier now the moment you looked up at me like that.

I turned the razor on.

It became real then.

I fumbled my way through the already thinning patches of your scalp. I felt unsure, unready, wielding that razor. Shouldn’t I know how to do this, shouldn’t everyone know from the movies? They do this all the time in movies, this moment right here. But they don’t tell you about how heavy that razor is in movies, they don’t tell you how much steel can weigh when you look at me like that.

You made a joke like you always do - that Irish bleak humor never turns off, not even for a second. I laughed. I appreciated it.

You could tell how hard this was, I could tell how hard this was, but we just kept staring and not seeing, not actually. But we knew, and we kept that secret, you and me, between ourselves and the hushes and that heavy, heavy razor.

I finished and cleared some stray hairs from your crown, and you sat (admiring yourself, I liked to imagine). Seeing yourself, that terrifying feeling of seeing yourself, and while you were seeing yourself so was I. I was seeing you, actually. For the first time, maybe.

You were thinner now, medications already starting to wear on you. But you looked determined. But you looked scared. But you looked at me and I knew you were looking at me as equal now, because I was seeing you for the first time. How is it that after sixteen years I am only now seeing you for the first time?

We’ll be okay you said. That ‘we’. The ‘we’ that meant we were in this together, as partners, as equals, that ‘we’ that made up that hushed language, that ‘we’ that had been weighing down on me since you pulled over that car on that sunny afternoon in April and you told me that you had breast cancer.

Yes, that same ‘we’ that made me know we—you, and me, and Jill—we would all be okay.

Claire Stauffer is a senior at Boston College, where she is double majoring in Biology and English. This piece was originally published in The Medical Humanities Journal of Boston College, Volume 1, Issue 2, Fall 2015.

“Kate, I just got a call from Jane. She wanted to know whether we wanted to go…wanted to go to…”

My mother closes her eyes and scrunches her brows together as she says this, trying to find the word in her brain.

I ask, “Whether we wanted to go to church with her?”

As my mother then thanks me, I try to hide my unease.

Such exchanges – in which my mother forgot a word or an entire idea, and I completed her sentence – began when my mother was only 51 years old and I was a sophomore in high school. By the end of my senior year, my mother's condition had worsened to the point where she could not comprehend my daily notes, which only said when I would return home from school.

My mother emotionally changed during this time as well. She often became angry, especially when she attempted to deny her memory issues. Sometimes, though, her denial gave way to sadness, as she accepted her new truth: she had the memory struggles of a much older woman.

Both of these emotions – anger and sadness – underline how difficult my mother's memory problems were and still are, for her and for my whole family. We all struggle. We watched her undergo a staggering change – from an exceedingly intelligent woman who graduated magna cum laude from college to one struggling to read.

Despite these clear symptoms, help was difficult to find. At first, my mother attempted to empower herself and take action. She reached out to a local health case management organization that accepted her state insurance. This facility provided her with samples of trial medication to hinder the progression of her memory loss. Struggling just to pay rent, we could have never afforded these medications on our own.

My mother regularly took her medication. She did crossword puzzles. She felt hope – until the organization’s medication samples ran out. She came home from her appointment that day and declared that she would never go back.

Ultimately, my mother would need to visit a geriatric health center specializing in care for the elderly in order to get a formal memory examination and brain imaging. With state insurance, we waited for months to get an appointment. It took a full three years to get a diagnosis, though we were grateful to have the costs covered.

In the end, my mother was diagnosed with Frontotemporal Dementia (FTD), an illness I had never heard of before. This disease has no clear causes or risk factors, except for possible genetic inheritance, and no known treatments. It causes shrinkage in the frontal and temporal areas of the brain, often at a young age (between 40 and 70 years old), resulting in emotional liability as well as memory problems. As in my mother’s case, it is often initially misdiagnosed as mental illness. This is not necessarily the physicians' fault, however; FTD and certain psychiatric disorders manifest themselves in remarkably similar ways. This is a small reminder of how health challenges connect us all.

Once my family and I learned that my mother's true illness was FTD, we were overwhelmed. We were shocked by the devastating emotional changes that would come with FTD. We also had to learn how to navigate the modern health and legal systems. As my mother became increasingly dependent, and we focused on issues such as paying her bills and finding her a safe place to live, we had to simultaneously “prove” her disability in court. Now, my father has acquired the title “Conservator of Person” so that he, with input from me and my siblings, can make decisions on my mother’s behalf. This isn’t easy.

My mother does not recognize that she has memory issues. Without realizing it, she often acts like a child. She cannot participate in society, or even in our family community, like she used to; she cannot read the newspaper or even a simple word, and she lacks the emotional stability to maintain relationships. She craves attention from others, though, and will even have temper tantrums when she feels ignored. I have watched my mother stomp off to her room, sulking, many times.

One of these temper tantrums actually caused her first adult daycare center to dismiss her. The employees at the center felt that my mother agitated other clients against the caregivers. Perhaps she did, unintentionally; my mother does quickly become anxious and upset when she is not actively engaged in an activity or when her day deviates from routine.

She dislikes boredom and harbors a longing to be helpful – an impulse which often goes unrecognized by society. My mother is actually quite eager to perform simple tasks, like setting a table. She loves to feel usefully engaged and be an active participant in chores or activities.

I am grateful that my mother can actively participate in this way at her current daycare center. Here, she feels safe and full of purpose. My mother loves to attempt to help other clients. She often talks with them when they feel sad or upset, and this truly helps other clients to manage their emotions. My mother also participates in art therapy, pet therapy, and simple sport games, along with other clients. She really enjoys the social, recreational atmosphere that the center offers her.

At this center, my mother's caregivers provided her with a community and a purpose. They support her and treat her with compassion. To them, my mother is an adult woman – which seems to be a simple thought yet is actually a profound affirmation of a dementia patient, who is often stereotyped for immature behavior and simplicity. Dementia patients are adults, although they might act like children, and they deserve to be treated as such. Surrounded by such positive treatment and respectful attitudes at her daycare center, my mother has been happy in the past few years.

But with the passage of time, she now needs more intensive care. She struggles more, internally and externally. Her emotions have become quite explosive and unpredictable. Daily activities, such as bathing or brushing her teeth, have become lengthy and complicated exertions. My mother's daily hygiene routine is a particularly potent source of frustration and stress for her, and this exemplifies how her internal and external conflicts are quite connected. Dementia has affected my mother's physical abilities and personality, as well as her memory. With dementia, and perhaps with illness in general, the physical and the internal are often intimately connected.

This connection between the physical and the emotional can make care-giving a complicated endeavor. My father is currently struggling to completely care for my mother, when she is not in adult daycare. My mother definitely needs full-time health services, but they are difficult to secure. Because of the high demand for a spot in a specialty care facility, immediate placement is rare unless it occurs in in the aftermath of a hospitalization. My mother has been on wait-lists at multiple long-term care facilities for more than two and a half years. For now, I am incredibly grateful that my father and her adult daycare center are able to meet most of her changing needs and desires.

My family’s experience with FTD has changed me. Now, I am committed to advocating for greater health resources for all, especially the most marginalized. While my mother's illness is rare, I hope that my family’s story encourages others to work for broader change. I hope others contact legislators about extending health care access for patients and caregivers.

More generally, I hope my mother's story can also increase awareness that different kinds of dementia exist. Some dementia patients, such as my mother, can remain quite active participants in particular communities. Though individuals struggling with dementia have gone through much personal loss, they may retain their desire to be involved and help others. They can help others, and have much more to offer than one may initially think – if their community will accept them.

As a student in college, I imagine the possibility of experiencing dementia myself in the future. I know what it is like to worry about the shortness of life in the face of medical difficulties. In this way, I feel I am connected to many others – to other students and to other individuals in general – who experience and observe a myriad of health challenges every day. Despite the fragility of health, we can be conscious of all that we have and try our best to always value and make the most of our time.

Katherine Divasto is a member of the Harvard College Class of 2016 and is a Psychology major.

My name is Nancy Marks. I have been a Boston-based printmaker and painter for more than twenty-five years. In addition to solo exhibitions, my work has been displayed in galleries, restaurants, and corporate settings. I am also a public health advocate and art teacher who is committed to helping others use art to engage in personal healing and community dialogue.

In 2014, I created The Intimacy of Memory, a body of mixed media paintings based on grief, love and remembrance. The work examined why people chose particular objects or keepsakes after someone close to them died. I was interested in the ways in which an object represents the person who died and the shared relationship with the survivor. How do objects celebrate a life? How do objects prompt memory and how does this memory change over time?

This body of work seeded itself fifteen years ago when the biological mother of my adopted daughter, Taylor, died of AIDS. Taylor was six at the time. As I cleaned out her mother’s apartment, I had to decide what to keep. Which items would hold memories of her mother and offer Taylor comfort both in the moment and throughout her life? As I selected a few dishes, her mother’s favorite shirt, a locket, a mirror, I knew it wasn’t just what I kept but also what I didn’t keep that would play a role in Taylor’s recollections.

As part of this exploration, I interviewed participants and meditated on what I had heard. When I began to paint, the layers of color seemed to mirror the layers of their recollections: feelings of loss, love and longing. While many details faded into the background, what I felt most acutely was the sense of connection that stretched from the present to the past. I began to see how relationships and roles become fixed in time and space at the moment of death. How we forever remain mother/father/grandfather, husband/partner, sister/daughter/granddaughter.

As I exhibited this work throughout Massachusetts, I started to feel that I wanted to more closely connect my art life with the power of personal narrative. Since this initial body of work, I have begun to host Intimacy of Memory workshops.

The Intimacy of Memory workshops are designed to allow participants to make art based on the objects they kept after a meaningful loss in their life. It approaches the complexities of grief and love using art as a central connector. Because so many don’t have language for loss, art can play a pivotal role in communicating emotion and promoting healing.

Whether the loss is fresh or long past, this workshop gives artistic space and voice to the grief and love you may have been nursing privately. While the subject is heavy for many, there is often laughter and joy as people share memories.

But the work doesn’t stop there. After a workshop, participants are encouraged to hang their art in public space. The goal of the public exhibition is to promote a community conversation about death, grief and love, three subjects that are often privatized in the broader culture. I know how deeply painful loss can be, but we make the healing process that much harder by not giving our losses adequate  "time.” After all, grief is really just remembering how much we love and miss those we have lost.

This originally appeared in Modern Loss. Republished here with permission.

I gave my inaugural eulogy at fourteen. When my best friend Liz passed away from osteosarcoma after one year of unsuccessful treatment, her mother asked if I would share something at the service. I seized the opportunity, as it seemed like a potential antidote to the grief roiling inside me.

For days, I immersed myself in boxes of photographs and stacks of letters that told the story of our friendship. I spent hours feverishly recording my memories, depicting her mischievous smile, glittering eyes, and elegant voice. On the morning of her service, I rose to the pulpit with quivering hands but a strong heart, and delivered a eulogy that was humorous, commemorative, and authentic.

Little did I know at the time what an extraordinary journey this act had launched—into myself, into writing, and into healing.

To read more, click here.