Letter To A Widow

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I remember when I first read the pathology report on my patient, Mr. Jackson (not his real name), my stomach flip-flopped.  “Adenocarcinoma of the pancreas” it said. A week later, a CT scan revealed the cancer had already spread to his liver. Two months after that, following six rounds of chemotherapy, around-the-clock morphine for pain, a deep vein thrombosis, and pneumococcal pneumonia, he was dead.

His wife called me to tell me he’d died at home. I told her how much I’d enjoyed taking care of him, and we shared some of our memories of him. At the end of the conversation I expressed my sympathies for her loss, as I always do in these situations.

There was a brief pause. “It just happened so fast…” she said then and sniffled, her voice breaking, and I realized she’d been crying during our entire conversation.

“I’m so sorry for your loss,” I told her again. She thanked me for caring for her husband and hung up.

I’d known Mr. and Mrs. Jackson for almost seven years and had always liked them both. I thought the world a poorer place without Mr. Jackson in it and found myself wishing I’d done a better job of consoling his wife, thinking my attempts had been awkward and ineffective. I reflected on several things I wished I’d said when I’d had her on the phone and considered calling her back up to say them.

But then instead I wrote her a letter.

Navigating Loss

Dear Mrs. Jackson,

When you called me to tell me your husband had passed away and how hard a time you were having, I found myself frankly at a loss. Conventional wisdom about how to console people who’ve suffered grievous losses includes platitudes like “be there for them,” “listen,” and “let them know you care”—all valid and useful guidelines that I’m sure have brought comfort to many suffering people. But inevitably conversations end, people go home to resume their normal lives, and the wife or husband or son or daughter is left alone with pain now occupying the space their loved one used to be. Though I don’t know how comforting you’ll find this letter, I wanted to share with you some of my thoughts about grief in hopes of making your journey through it somewhat more bearable.

Why do we suffer when we lose those we love? I think the true answer is because we believe we can’t be happy without them. Knowing how much you loved your husband, I can only imagine how strongly you must feel this to be true. And yet I often think the only reason the pain of loss abates at all is that we do become convinced we can be happy again—just slowly and unevenly.

Certainly, some people find themselves stuck in grief, unable to move on. Sometimes this happens because we actually become reluctant to surrender our grief even after it’s run its proper course, believing the pain of loss is the only thing keeping us connected to our loved one, or that to feel happy again would be to diminish the significance of the relationship we once enjoyed. But neither is true. Even when people we love die, our relationships with them do not. We continue to have feelings about them, memories of things they did, imaginings of things they might say were they with us now. Just because the pain of losing them diminishes with time, their importance to us need not. Normal grief is like a roller coaster: there are ups and downs, moments of pain intermixed with relief. If, however, after the first six months or so there seem to be fewer periods of relief rather than more, normal grief may have changed into full-blown depression. If you think this might be happening at any point, please let me know. I can help.

  • Everyone grieves differently. Don’t ever let anyone tell you how to do it. If you want to talk about your husband with others, do. If not, don’t. There’s definitely something mysterious about the human psyche, some intrinsic force within us that continually seeks to engulf pain and suffering the way our white blood cells engulf viruses and bacteria, an elixir we seem to swallow at the very moment our loss occurs that immediately begins to work on our suffering without us even knowing it but which nevertheless somehow eventually cures us of it. After experiencing a devastating loss, if you’ve allowed yourself to feel the legitimate pain it’s brought and not sought to avoid feeling it, things slowly start to improve. We wake one morning to find there’s something in the day we’re actually looking forward to; or someone says something funny and we actually laugh; or we find ourselves able to plan things again, even if only a trip to the grocery store. But there’s no definite timetable for this. Don’t allow anyone to hurry you along with their expectations about when your grief should end.
  • Just know that it will. It may seem to you now, while in the middle of the worst of it, that it won’t, that your happier self was only a dream and that this grieving self is here to stay for good. But that’s an illusion brought about only by your current life-condition. Nothing is forever, including the pain of loss.
  • Don’t grieve alone. I worry that you have no one with whom to share your grief (you’ve told me in the past how you were all alone except for your husband). While you may not have much energy for this, I find myself hoping you’ll join a support group, either at your church or by looking online. There’s something often magically healing about spending time with others who’ve had or are having painful experiences similar to your own. It may seem an overwhelming prospect now, utterly beyond you, but often by holding someone else’s hand, by becoming their support, you’ll find your own pain lessens just a little bit. When you shine a light to guide others on a dark road, your own way is also lit.
  • Forgive yourself your failures. You said on the phone you “felt guilty,” but not what you felt guilty about. I wondered about that. I wondered if you felt guilty about having spent time doing things like seeing other people or watching television rather than spending every moment with him; or about feeling tired of caring for him; or about not always having a positive attitude when you were around him; or for wishing the nightmare of his illness had actually ended sooner—or any of a myriad of things family members have told me have made them feel guilty, too. Or maybe you feel guilt about the decisions you made when your husband was no longer capable of making them himself. The end of a person’s life is often composed of gut-wrenching choices that land squarely on the shoulders of family members: to put in a feeding tube or not; to use mechanical ventilation or not; to use heroic measures or not; to decide not to press forward with an intent to cure but rather with the intent to palliate. I know you struggled mightily with the decision to stop treatment and bring him home to be comfortable, but you must know your decision did not cause his death. His disease did. His disease is what thrust you into a situation you didn’t ask for or want, but accepted with grace, making every decision with as much deliberation and wisdom as you could muster, even when you were exhausted, and always with an eye towards his comfort.

Forgive my presumption, but if you feel guilt over any of these things—or over other things I didn’t mention—you must forgive yourself. There was never a need for you to be a perfect caregiver—only a caregiver who cared, and that you most certainly were. The person who gets sick is never the only one whose life is deeply affected by their illness. This was your experience, too.

I want you to know that watching the way you were with your husband always inspired me. I can only hope to face losses in my life with as much courage, acceptance, and humor as you and your husband did both.

While no one knows what happens when we die, we can say with certainty that we lie between two equally inconceivable possibilities, one of which must be true: either the universe has always existed and time has no beginning, or something was created from nothing.

Either case makes every one of us a miracle.

With my warmest regards,

Alex Lickerman, MD

In loving memory of Rik Campbell and Bob Shurtleff

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  • I am in tears reading this over again. Beautiful.

  • Thank you for this—my boyfriend’s grandmother just died and he was very, very close to her. She practically raised him, and she was the one person he always felt safe with. I’m hoping he can find something comforting in your writing.

  • Hi Alex, thank you very much for sharing this wonderful letter. It is VERY timely and reconfirms my belief in synchronicity. My grandmother just passed last Thursday. Although it was not a sudden death—she was 95 years old and had a traumatic fall which put her in hospital and eventually took her life—it has been very difficult to deal with for myself, my father (her son) and many of our family members. I have found myself digging deep these last few days to reflect and contemplate many of the topics which you have written about in this article. I am loving that you posted and shared this with us today. Thank you.

    With much love and admiration to you and Rhea,

    xo Leslie

    PS—I am going to share this article with a few other grieving family members and I am sure it will enlighten them as it has done for me.

    Leslie: I’m so sorry to hear about your grandmother. I’m amazed at how many people I know have suffered losses so recently. I’m really glad you found the post helpful.


  • Hi Alex. I have never read something so beautiful, honest and inspiring. I went through so many different emotions when my ex-husband passed and guilt was at the top of the list. To this day it sometimes takes my breath away when I think that he is really gone, and it’s been 3 years now. My eldest daughter will benefit from this wonderful and heartfelt letter as she also feels a horrible sense of guilt. I know this letter with help Nevin’s (my ex) Mom she is having such a hard time dealing with her son being gone, I can’t wait to give her a copy.

    Thank you again, and God Bless.

    Jennifer Low

    Jennifer: I think the premature death of a loved one is simply the worst. All the things people feel when an older person dies seem just to be magnified several hundred times. I hope your daughter finds this helpful.


  • Alex, thank you. Deeply appreciated by me and I believe will also be helpful to sister Susie and sister-in-law Nancy in dealing with their loss.

  • Alex,

    Thank you so much for dedicating this to Bob and Rik. I too felt guilt after Bob had passed away for all the reasons that you gave. The days do get better and I do laugh lots often about crazy things we used to do. I even talk to him and ask his opinion but he does not answer …and I chuckle. I will always really miss him as we were together for so long and he was my best friend. Again thank you for your dedication and the opportunity to share your blog.

    Susan: I’m so happy to have been able to do it.


  • Alex,

    Thank you. 2009 will mark the 10 year anniversary of my mother’s passing. I can’t believe that it has been that long. Reflecting back, I witnessed immense compassion from Mom’s nurses, as she was a nurse herself. While I absolutely believe that Mom received great care from her doctors, I never felt that they connected with her as a fellow human being and treated her soul. Perhaps, the emotional cost of a physician connecting with a patient comes wiht great burden.

    Thank you for reaching out to Mrs. Jackson…for putting yourself out there and connecting with her. Thank you for reaffirming that there is hope in the clinical world and your fellow practioners. I know that Mom is smiling at you right now. You’ve taken a page right out of her book.

  • Alex, thank you for sharing your experience as a physician dealing with death, and thank you for dedicating this message to my brother and brother-in-law. You are what I call a true physician, as opposed to a mere doctor. Your depth of caring for your patients and their families is indicative of the depth of spirituality that governs your life. Again, thank you.

  • I’m crying again! This sentence got me: “When you shine a light to guide others on a dark road, your own way is also lit.”

    Thanks for sharing it—I’ll pass it on. xo

  • Thank you for sharing your touching and beautiful thoughts on helping others to deal with losing a loved one. While the words didn’t come easily or immediately for you (over the phone), your letter certainly shows that you have the heart and compassion towards humanity that I wish all humans would possess. The world would most certainly be a better and happier place with more people like you. I’m looking forward to your next words of wisdom post and thankful for your invitation to join your site.

    I will copy this letter and share it with others experiencing grief.

  • Wow, Alex. This is perfect for my mom with my father’s passing in July. I’m sending this to her. Thank you so much.

  • Thank you for this beautiful letter, and for other wonderful posts on your blog. As a writer on the human/animal bond and pet loss, I believe many of your thoughts on the grieving process are also helpful in dealing with the loss of a furry family member. The paragraph on guilt feelings is especially helpful. Having recently lost a beloved dog, I recognize some of the guilt feelings experienced by a loving caregiver. As the daughter of 93 and 95 year old parents, I am trying to prepare myself for their loss as well. Nothing can ever prepare you for the loss of family, but I will add this letter to my file of helpful writings. I know I will re-read it when the time comes, and in the meantime share it with others experiencing loss. This post will touch many lives.


    Celebrating the love of dogs at http://www.laurelhuntbooks.com

    Laurel: I absolutely agree the post applies to animals we love and lose as well. No question that people can become as attached to their pets as to people (if not more!) and therefore grieve over their loss just as strongly.


  • […] Grieving styles.  A psychologist friend of mine once suggested that couples don’t divorce because they suffer devastating losses, but rather because they have incompatible styles of grieving.  (Or because one partner refuses to let the other grieve as they wish).  Unfortunately, most couples will eventually grieve together over something.  I discussed grieving and grieving styles in a previous post, Letter To A Widow. […]

  • […] […]

  • […] the truth is you can even if you don’t want to be.  As I wrote in a previous post, Letter To A Widow, having lost a loved one we sometimes become reluctant to fully surrender our grief even after […]

  • Thanks for pointing me to this, Alex. I was particularly taken with the idea that everyone grieves differently. That was certainly true in my own family, where the emotions really ran the gamut. I woke up the other day and forgot for a moment that my father had died. That’s also part of grieving, I think. Anyway, this was lovely. Thanks for sharing.

    Delia Lloyd

  • I am so happy to have found your blog (via a link from today’s NYTimes on cycling and bone loss). My husband died five years ago at the age of 48 (esophageal cancer) and I still struggle with the loss at times. Your “Letter To A Widow” summarizes much of what I have experienced and reinforces my attempt to live well and learn from this painful loss.

  • Alex—I found your “letter” from a link in an article in the NY Times. I related to so many things that you wrote. I lost my husband to cancer 5 years ago. He was 44 years old and our children were 9 and 11. I particularly agree with your description of grief as a roller coaster and of becoming happy again—albeit slowly and unevenly. As a young widow, I’ve had to also deal with the grief of my in-laws and my children and many many other people in our lives. It’s not an easy task but I’ve done my best. I do encourage anyone in my position to put their kids in a support group with other kids in similar situations—the parents met separately and that was invaluable too. I think about my husband and all that we lost when he died nearly every day, but then I put it aside—and live.

    Carole: I hate hearing about situations like yours, but I’m so encouraged to hear how you’ve managed. Your point about putting kids who’ve lost parents in support groups that are separate from adult support groups seems excellent. I think a lot of what we do as human beings in life is simply endure and continue on.


  • I found this article from your link from the NYTimes. I lost my grandmother on Thursday. She had a beautiful and fruitful life, but I am worried about my grandfather’s grief. I am at a loss as to how to help him, but this article is comforting.

    Kimberly: My condolences on your loss. It’s so hard to find the right thing to say to someone who’s lost a loved one. Perhaps it’s better not worry that what we say is “right” but more that whatever we say is said with comforting intent. In whatever words that intent is cloaked, it’s always recognized and is never wasted.


  • I, too, came from the link in the NY Times and I’m so grateful that I followed it. Your heartfelt instruction on grief applies to most kinds of grief, I think. I know reading this has helped me in the work to get over a five year relationship that I really miss and often mourn. Life is not fair and sometimes it’s hard to come to terms with that fact. I have had some practice because I lost my grandmother, my uncle, and finally my mother. Now I am the last living relative of my entire family because my father died in WWII when I was four. There are some things to be said for living alone but singleness begats loneliness and sometimes regret. Life is what it is, and sorrow visits everyone by the end of life. One day, as you said, the sun shines again and we go forward.

    Thank you so much for this beautiful letter. I wish you were my doctor.

    Sandy: It is true, I think, that singleness can begat loneliness, but new relationships, friendships and otherwise, are always possible. After you’ve given yourself time to heal, however long that takes, let the sun shine again in your heart and what feels possible there will actually become possible in your life.


  • Is there a book you could suggest to help me with helping my mom’s grief over losing her husband to IPF?

    Jenna: A colleague recommended the book Grieving Mindfully by Sameet Kumar. I hope this helps you.


  • Alex,

    Thank you for your post. The things you have mentioned about grieving I believe apply to any kind of loss, even breakups which can be incredibly painful.

    It is easy to “move on” on the surface, but it is incredibly hard to sit with the sorrow, process, and grow. At times it can feel as though one is drowning and will not survive, but as my father once told me—time heals all wounds. This from a man who lost his 6 yr daughter (my middle sister). Just that some wounds take longer to heal, if only we have the patience and perseverence to go through the process; we will surely see the rainbow at the end of the tunnel.

    By taking the time to grieve, perhaps someday we might be able to hold another’s hand and say, “I totally understand how you feel.” Nothing can be more powerful than those words which makes us feel, “I am not alone.”

    Once again thank you for your posts.


    Vasavi: Very powerful to hear your dad say that to you after having lost his daughter, your sister. And I couldn’t agree more with the sentiment that having gone through painful losses positions you to help others weather similar storms. No one can encourage us as well as other people who’ve already gone through what we’re going through now.


  • Alex,

    Thank you for this! My husband died a month and a half ago.

    I had the most beautiful life with him…this letter has been a great comfort…as we were actively involved together in the dying process I feel so lucky and mourn for those who did not have time to do so…it is hard enough losing your mate of 31 years, but to have lost them without time to say what needs to be said, to hold, to comfort each other, I cannot imagine…

    Warmest Regards,

    Leslie: My most heartfelt condolences on your loss. I’m so glad you found the post comforting. It’s just so hard to lose people…


  • Thank you for this.

  • I am so thankful that you took the time to write what is so true! My sister was killed in a car accident the day after Thanksgiving 2007 at 35 years old. And even tonight I told my husband I still have to remind myself that she is gone because forever is too much to handle for me. Not that I am in denial; that is impossible when I can no longer see her or talk to her in the human form. I think you are almost closer with those who have gone because they are with your every thought; it can be a beautiful thing. I was pregnant with my first daughter when my sister died and I named my daughter Samantha after her. New life makes me realize that life must go on and I must be present, as impossible as that seems at times. All I can do is take it one day at a time and hope with God’s grace and Sam’s, that I will learn to adopt this new life of mine without her. My family and I always say at least we were blessed to have had her in our lives. Some people go their entire lives without having someone so special to call a sister or a daughter or a wife or a mom. Even though I will probably live longer without her than I did with her, the pain is worth having her as my sister. Thank you for your letter!!

  • Thank you so much for this…my friend, Paul, passed away September 16 of signet ring adenocarcinoma of the appendix. He was 37. His wife was his caregiver, and the empathy so eloquently described in your letter really hit home. Coming to terms with Paul’s passing was difficult; it was a year of grieving as we watched this disease ravage and rob an extraordinary man of life, but never touched his spirit. I believe much of that was due to the phenomenal love and care of his wife. I can’t begin to imagine what she is experiencing, but I think your letter gave me insight. I’m sending her the link to your site afternoon.


    Heather: My condolences on your loss.


  • What a wonderful letter! My husband died nine years ago at Christmas. He wasn’t feeling well, tests were run, surgery performed, and a diagnosis of stage 4 adenocarcinoma was made. They had no idea where the primary site of the cancer was. He died 11 days later. An autopsy revealed that he had a rare, aggressive form of prostate cancer. I was 41 years old with three teenagers. I only wish someone had wrote me a letter like the one you wrote. I clearly remember the first time I laughed out loud…three months later. I was startled to hear myself and immediately stopped feeling guilty that I was laughing. Time does lessen the pain. Thank you.

    Lori: You’re so very welcome. My condolences on your loss.


  • I found this post from the link in the NY Times. Thank you for the letter—I found the letter and other people’s replies to the letter very comforting. My father committed suicide last Thanksgiving and it’s been very difficult for my mother who has been married to him for 46 years and for me, his daughter, to deal with the tragedy. My mom in particular is having a hard time as she both feels guilty for his death and angry for what he’s done to her (in Chinese culture there’s immense shame and humiliation when there’s a suicide in the family and due to superstition, she’s afraid to live in the house again). Like Julie, I was pregnant when the death occurred and I find myself endlessly speculating the whys and what-ifs whenever I have a free moment to myself (usually late at night after the baby is asleep). Thanks for the reassuring letter. I will try to forgive myself and pass along the contents of the letter to my mom.


  • […] how they felt and treated their dying loved one (for a more thorough discussion of this topic see Letter To A Widow), and an inability to come to closure regarding rifts in […]

  • My husband passed away on November 8, 2009. He died of metastatic thyroid cancer. We were married for 35 years. He was a wonderful husband, best friend and my soul mate. I took care of him at home, he passed away in my arms with our two children at his side. We said the Lord’s Prayer, our daughter sang Amazing Grace and Silent Night. He passed away peacefully at the end of Silent Night. I have a hard time getting through each day without him and miss him dearly. Thank you for your wonderful article, it made me feel at peace. I will keep it and refer to it often, to help me get through my grief.

    Diane: My condolences on your loss. I’m glad you found my post helpful.


  • I chanced upon this post today as I was reading a recent post. I can’t even tell you how much it has helped me cope with the death of my grandmother who passed away on 20th Jan, 2010. I was brought up by her and she was the only one who loved me and accepted me unconditionally. Although I was there during the time she was unwell I do feel guilty for the times I didn’t sit with her in her conscious moments owing to other compulsions which seem so trivial now…

    Sherry: I’m so glad you found it helpful. My condolences on your loss.


  • I lost my husband 10 months ago. The first seven months, I just couldn’t pull myself together. Thanksgiving was rough, and Christmas was horrible. Once the holidays passed, I began to get a perspective on my life. I cried a little less each day, skipped a couple of weeks from going to the cemetery. When I think of him my heart is still breaking, but as the saying goes, it takes time.

    Richard was a wonderful husband, father, grandfather. His granddaughters still talk about all his stories and jokes. While everyone else has moved on with their lives, I’m still trying to grasp mine. I know in time I will be happy again.

    What I liked most about your letter is not allow others to tell you when to stop grieving. Everyone does it differently, and for different lengths of time.

    I’m a progress in the works.

    Thank you for that wonderful letter.

    Ruth: You’re very welcome. I hope it may comfort you to know also that research data actually shows most people who lose spouses do eventually return to their previous level of happiness. Please be patient with the process. There are no shortcuts.


  • I believe those who interact with you on any level are fortunate, Dr. Lickerman. I believe patients in the final stages of life along with their loved ones are particularly blessed. From what I have gathered from the reading exploration I did, your compassion and understanding has not developed through personal experience of spousal or child loss, but you write as if it had.

    My husband died in 2001. Fighting my way through grief and finding my way to life after my husband’s death has been the most difficult task of my life—thus far, yet I cannot imagine there will be anything to come that could compete with it. After attaining my grief legs, I became a cyber companion to those who follow behind me and who also find the website and discussion board I started.

    I would like to include your Letter To A Window on the website in the Author’s Contribution resource page and on the discussion board, possibly on both the Inspiration Corner and Rules for Widowhood threads, if you will grant me permission. Proper attribution and link direction would be given.

    Thank you for the compassion and the wisdom you show to others and for the light you so kindly shine for them in their darkest hours.

    Marilyn: I’d be delighted.


  • Your letter is so open, knowing, so consoling.

    Fourteen months after my husband’s sudden unexpected death, I still come to a full halt when a tiny memory string is plucked. Last week would have been both our birthdays and 36th wedding anniversary. Last year that week passed in a blur. My friend-families, my own children living across the continent walked and talked along with me last week, yet I still think he’ll appear and I’ll share what happened and how I am making new traditions, seeking different reactions, and finding small happinesses as he would wish for me, day by day. His athletic heart was so strong that regular stress tests usually went double the time w/o raising anything, so they simply stopped each one. At his end, it was the cause of his death, just as it had been the cause of his younger brother’s 10 years earlier at age 40. My consolation is that my dear husband attained age 60, didn’t die that young, though ~same cause~ his father died at 85 just before Christmas. My loving daughter-in-law is a genetic biotech and keeps repeating “genetics” whenever the guilt train stops for me and I’m almost on board.

    He will always live in my heart: life is short but love so very long. I think the hardest thing was not getting to say “good-bye” and the fact that I coded after one surgery and consciously said 3 times, “I’m not ready to go,” as I saw his stricken face, and turned away from the light and out-of-body experience. I was later told, “We lost you,” but I had chosen to stay: 12 more years with him. But last year for months I bewailed the fact that he didn’t come back to me to forestall my own grief. Grief therapy really helps!

    I’ll pay the tear tariff for those “sidewinder” memory moments of the wonderful life we had together plus the struggle to not live my life in the rear-view mirror but charge ahead, always his desire for me, his hummingbird, as I faced dozens of surgeries and rehabs (successfully) for post-polio issues. That is him living in MY healing heart now, just under the scar tissue.

    Vicki: I was so moved by this wonderfully articulate, heartfelt comment. Your husband must have been quite a guy.


  • Alex, your letter was compassionate and no doubt comforting. For those seeking a book to help them deal with grief, I highly recommend Solace, by Dr. Roberta Temes. It is a beautifully written book that soothes and offers a tremendous breadth of information, with much practical advice in how to deal with the entire bereavement process. Reading this book will indeed help them achieve the solace they seek.

  • Hello, Alex,

    Thank you so much for this letter and for this website. I lost my husband of 29 years last July, and then his sister—one of my best friends since age 10—last month. I do attend a regular grief support group which has been enormously helpful. I’ve sent this letter to my daughters, nieces, and nephews.

    I would also like to introduce you to my online memorial art gallery, Shine On Brightly at http://www.shineonbrightly.com. We feature artist-made, beautiful, personal memorials—from cremation urns, to memorial paintings, jewelry, and more. I launched the business from my lifelong passion for art and people’s stories. It has since become a vocation for me. I hope you’ll check it out. I’d love the opportunity to work with you in that capacity.

    Adrienne: I’m so glad you responded to my post. And I think I’ve heard of your website! Did you get a write-up in a major newspaper at some point, or am I making that up? Your site looks beautiful and I’m sure is a great comfort to many who lost loved ones.


  • My husband of 33 years passed away on March 15, 2008 from a variety of health problems. Many of the causes were self-inflicted—smoking, prescription pain meds, and alcohol, which in turn caused so many problems. I have felt guilty for so long that perhaps it had something to do with me, and that I should have done more to help him get help—although I tried to make him get help time and time again. It becomes frustrating. After 2 months in the hospital, he passed away with our son by his side. I couldn’t bring myself to be in the room. I never thought I would be able to handle any of this, but I have. I have my work and our son and daughter, many family members and now new friends. I have found it difficult to move on and afraid to start any new relationships with men. Thank you for your letter. His physician wrote me saying he had enjoyed taking care of him—that was thoughtful, but didn’t seem to be enough. My physician said not to blame myself—that I shouldn’t blame myself. That is hard to do.

    Gail: My condolences. It is so easy to blame ourselves for the misfortunes of others, pointing as we do to times we enabled or could have acted and didn’t, but it’s almost arrogant to believe we’re so powerful that we can determine someone else’s destiny. You clearly cared deeply for your husband and fought as hard as you could to help him. None of us is in control of anything except ourselves (and then only indirectly). With others, the best we can hope for in most circumstances is to be a good influence. Please forgive yourself for that which wasn’t your fault as well as for that which was.


  • Thank you so much for this heartfelt letter…I value what you write very much to Mrs. Jackson…she is all of us, past, present, and future…how true when you write, that the illness not only affects the sick person, but also everyone else in this person’s life…brightest blessings to you and yours…e*

  • Dear Alex,

    What a marvelous insight you have into the human spirit. Thank you for your well-chosen words. I lost my husband on Oct. 11, 2005. My only marriage and it lasted 50 years! We were 20 years apart in age but as close as could be in all other ways of life. I still feel his presence all around me. I am finding it very difficult to move on and date. I know you should not compare your loved one to others but let them shine in their own light. Knowing that doesn’t seem to make it any easier. I find myself sabotaging every relationship I could encounter. Will I ever be able to open up to another man and give him what I gave my husband? They all seem so shallow today. Perhaps, it’s just the age or the baggage? I truly want to let my light shine again ( :

    Warm Regards, Jean

    Jean: Compared to 50 years of marriage, 5 years of grief seems not too long. It sounds like you’ve made good progress in returning to life after losing your husband, but that final step of looking for another companion takes even more time than bereavement. Be patient with yourself. That light hasn’t gone anywhere. It’s just choosing the right moment (and man) to shine for again.


  • Thank you for this post.

    My father passed away on the 19th, after about 3 months in the ICCU. He had ARDS and all the complications that follow. We ran out of antibiotic classes by the end.

    I’m trying to get back to normal—today we had the 13th day ritual after which the soul goes its way in the cycle of rebirths.

    Despite being there 24 by 7, the what-ifs plague me.

    Austere: Give yourself time to grieve. This is a fresh wound you describe.


  • This beautiful letter was posted on my Facebook profile by a dear friend, who recently lost her husband to cancer. He died far too young; early forties.

    I truly hope that she has found comfort in what you have written; obviously she must have; the reason for her having posted it!

    Thinking of them both every day.

    Thank you for sharing this letter xx

  • Alex,

    Thank you for the beautiful, genuine and heartfelt letter. Taking the time to share this with others is a gift to all of us that have lost the love of our hearts. I remarried after a failed 30-year marriage. My new husband and I were a wonderful fit. We enjoyed each other tremendously and after a whirlwind romance we decided to marry. A few days after talking of marriage we were told that Keith had stage four, metastasized, bile duct liver cancer. We married two weeks later and enjoyed 7 months together.

    The piece of the letter regarding guilt was certainly something that I needed to read. I thank you. I wanted so badly to give Keith a wonderful life. I have many times found myself in deep grief and tears that seemed to never end when going over my caregiving. Your letter gave me some relief and will be another tool for me to use in taking the steps necessary for me to go forward without guilt.

    Desperate loneliness and deep, burning grief creep up. This will be a letter that I will read over and over until I begin to feel more alive again.

    Many thanks,

    Cathy: My condolences on your loss. So very sorry to hear of it.


  • I’m happy this letter made you feel better. I would like to share what a caring doctor said to us in the last stages of cancer. She was talking in our room, asked politely if my husband would mind if she brought in a medical student. My husband agreed. This was part of her teaching: “I would like you to pay close attention to what I say next. How Fred happened to be here today is beyond us. It is our privilege to be able to treat Fred today, not the other way around. Many in our profession have lost sight of that.”

    Look into the seas, doctor, you are not at the wheel. The patient is steering the ship. Good for you for trying. I hope you will take time to reflect across these years and will mature with your experiences beyond that opening letter to a true caregiver.

    Keep trying.

  • […] this—but the truth is you can even if you don’t want to be. As I wrote in a previous post, Letter To A Widow, having lost a loved one we sometimes become reluctant to fully surrender our grief even after […]

  • You wrote: “You said on the phone you ‘felt guilty,’ but not what you felt guilty about. I wondered about that. I wondered if you felt guilty about having spent time doing things like seeing other people or watching television rather than spending every moment with him; or about feeling tired of caring for him; or about not always having a positive attitude when you were around him; or for wishing the nightmare of his illness had actually ended sooner—or any of a myriad of things family members have told me have made them feel guilty, too. Or maybe you feel guilt about the decisions you made when your husband was no longer capable of making them himself. The end of a person’s life is often composed of gut-wrenching choices that land squarely on the shoulders of family members: to put in a feeding tube or not; to use mechanical ventilation or not; to use heroic measures or not; to decide not to press forward with an intent to cure but rather with the intent to palliate. I know you struggled mightily with the decision to stop treatment and bring him home to be comfortable, but you must know your decision did not cause his death. His disease did. His disease is what thrust you into a situation you didn’t ask for or want, but accepted with grace, making every decision with as much deliberation and wisdom as you could muster, even when you were exhausted, and always with an eye towards his comfort.”

    I’ve been widowed since 2006, and I still suffer the consequences of his early departure from my and our two daughter’s lives. My husband’s illness was protracted (9 years) and brutal. No one came to comfort me or support me. No doctor ever said, “Your husband is terminal, you need support, here are some hospice people to talk to.” It was a nightmare I thought would never end and until he actually died, I was left to fend for myself.

    This one paragraph hits home hard with me. It is EXACTLY what I went through, and though it is remarkably insightful, no one who has not gone through this first hand can possibly grasp what a nightmare it actually is. Your letter to this woman was well written and well thought out. You did more good than you can know.

    M. Valentine: My condolences on your loss.