The Paradoxical Grief of Anticipated Sudden Death

Understanding Grief / Understanding Grief : Litsa


Lately, I’ve been thinking a lot about a grief phenomenon that I know is felt by many but doesn't seem to get much airtime. It's something I experienced in three significant losses in my life, something I've heard described by countless grievers over my years as a grief therapist, and yet it doesn’t really have a name in grief research and literature. I’m speaking about the grief that comes at the intersection of a loss that is simultaneously anticipated but nevertheless still sudden and shocking.

Perhaps just reading that last sentence offers insight into why that type of grief and loss remains in the shadows. It's not easy to explain; it sounds downright contradictory. We know what anticipatory grief is - there have been volumes written about it and research papers abound. Anyone who has had a family member or friend in hospice care knows what it means to anticipate a death and feel the grief that emerges before the end comes.

And most of us are also well aware of what sudden and shocking death means and the unique aspects of the grief that follows.

The loss and grief I’m trying to talk about, it somehow manages to be both of these things. It's a paradox. But like many paradoxes, it's a situation that seems contradictory at first, but deep down, it reveals a more profound truth. In this case, the (sometimes revelatory) realization is that in grief, anticipation and shock can co-occur. You can both prepare for the possibility of a death while also having that death be completely shocking and sudden when it arrives.


How Anticipated-Sudden Death Shows Up

In Illness

There is a long list of situations that can create this type of loss, and if you know you know. But in case this feels abstract, I'll start with some examples from my own life. When I was a teenager my dad was diagnosed with a potentially terminal illness. We were very aware of the inevitability that without a bone marrow transplant, he would die. But not long after being listed, while still very much still himself and not outwardly sick, he died suddenly of a rapid infection. It hit us like a ton of bricks. Yes, we knew all too well that he was sick. But the death also felt unimaginably sudden and shocking.

In Older Adults

Just a few years later, my 93-year-old grandmother died. Society loves to minimize the deaths of older people. So you're not alone if your first thought in reading that sentence was "the death of a 93-year-old can't be shocking!". I assure you, it can. I remember well just a couple of days after her death when I bumped into the young couple who lived next door to my grandmother. When I shared the news they both gasped. The husband exclaimed, "but she was just out here raking leaves last week!". They were even more shocked to learn her age - they'd assumed she was in her seventies.

My grandmother was 93, but she'd lived alone in her own home, completely independently, for thirty years. She worked a part-time job to stay busy into her eighties. She still drove and went to the gym and played bridge several nights per week. We knew her age. We'd of course anticipated that at her age death could come at any time - especially in the wake of my dad's death. But it was also blindsiding - there was no prolonged illness, no time to process the reality before it came.

In Addiction

Several years later, in the early days of the opioid epidemic, my sister's partner was battling a heroin addiction. If you have ever loved someone with an addiction, you know that feeling that every call might be the worst. In some ways, my life felt defined by the knowledge that an overdose could happen at any time – trying to prevent it and brace for it all at once. And though we lived in that fear every day, the shock still shook me to the core. It felt unbelievable when it happened, so much that I wondered if I'd ever anticipated it at all.


The Guilt of Anticipation

A silent struggle in this paradox, one that I suspect keeps it less discussed, is the guilt that comes with anticipating these types of losses. When someone's illness is terminal, if there are no further treatment options, part of the anticipation is acknowledging that there is no more hope for survival. Hospice professionals normalize the ways the brain starts to accommodate the reality of the impending loss and complicated feelings, like the relief, that often follow.

Unfortunately, we often conflate anticipation of possible death with resigning ourselves to the inevitability of that death. The assumption that anticipating means giving up hope makes people reticent to allow themselves to feel and acknowledge that anticipation. The shame leaves people struggling to sit with it, mention it, or process it. This guilt-driven silence sets the stage for shock to hit even harder when the anticipated-sudden loss finally comes. But this anticipation is normal and natural. It isn't a sign we've lost hope. It is our amazing ability to fully hold hope alongside anticipation of potential death that makes these losses so disorienting.


Give Grief Words

On the one hand, we're always cautious of labels and categories when it comes to grief. So often grief exists in shades of gray. And at the same time, without the words to describe the unique experiences of loss, people often find themselves struggling to find language for them, wondering if they are alone in their grief. I cannot count the number of times someone has shared their relief to learn a term like anticipatory grief, ambiguous grief, disenfranchised grief, or suffocated grief because it gave name to something they'd assumed was abnormal or unique to them. Labels can remind us that, though there are no universals in grief, there are many common and shared experiences.


Proposing a New Term: Paradoxical Grief

Why call it "Paradoxical Grief"? Well, the word "paradox" perfectly captures the mix of seemingly conflicting emotions. It's like preparing for a loss and still getting blindsided by it, all coexisting. By putting a name to this experience, we give people the power to express their feelings, creating a community of understanding, and spaces to research.

Paradoxical grief comes with its own set of experiences - sharing these commonalities helps break down the walls of isolation, creating a supportive space for those grappling with paradoxical grief. Anticipation doesn't erase shock, and shock doesn't wipe out the impact of anticipation. This dialectic speaks to the intricate nature of grief, challenging our preconceived notions and inviting a more nuanced conversation about loss.

Importantly, this experience isn't simply a little bit of anticipatory grief mixed with a little bit of sudden, unexpected loss. The combination of those things creates something unique. The confusion and dissonance of feeling things that seem contradictory adds their own dimension to grief, a dimension that can be hard to explain to others.

Sharing personal stories and collectively embracing paradoxical grief helps break the stigma around feeling both anticipation and shock, as well as validate their co-existence. If you relate to this experience, we invite you to leave a comment.

We invite you to share your experiences, questions, and resource suggestions with the WYG community in the discussion section below.

We invite you to share your experiences, questions, and resource suggestions with the WYG community in the discussion section below.

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After writing online articles for What’s Your Grief for over a decade, we finally wrote a tangible, real-life book!

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48 Comments on "The Paradoxical Grief of Anticipated Sudden Death"

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  1. Patti Jean G  May 2, 2024 at 2:32 pm Reply

    I am still surprised that my x-husband died. Nov 19th 2023. We were still close a d living together. I’m 73 he was 80. However, he was very strong and youthful. He was suffering from dementia. Slow progression of symptoms. I’m RN (Retired). I was shocked k ed he laid down for n ap 10 mins later I looked at him silently he slipped off to heaven. Another fa tor …my oldest daughter died 28 days before him. Not ex p acted. MY la n lady is harassing me with moving. I’m so isolated..I feel so many things.mainly my heart suck in my throat.

  2. Nancy  March 21, 2024 at 6:46 pm Reply

    I’m really happy that I came across your page. My mom cheated death over 12 times. Sometimes it was gross in confidence in the hospital and after many scary trips there and knowing she had congestive heart failure, she decided to go on hospice and I was her primary caregiver.
    I had already been taking care of her for two years, but then in February of last year she was brought home on hospice. I didn’t want to do hospice at first because I thought they were giving up on her. I then decided, along with my mom that I could take care of her better at home and I did for 10 months.
    She had several angina episodes or mini heart attacks but I medicated her and she always pulled through. She was our miracle. Then 2 weeks after her 83rd birthday, we made it a GREAT DAY FOR HER!!!! She was very energetic and clear headed the last week of her life. I couldn’t believe how good she was doing and we were online Christmas shopping then one day she woke up irritable. She NEVER was like that, so I helped her with some medicine and she went to sleep.
    Once she woke up she was confused. She knew what day it was but kept saying she had to go to dinner, it didn’t make sense and then over the next 40 hours she went from mom to little responses to none. I was medicating her as instructed and she could hear me when I told her to open her mouth but she couldn’t respond. It came completely out of nowhere and before I knew it hospice came and said she was transitioning. Wait, what?
    None of us in the house were prepared for that, even though she was on hospice. It’s like cognitive dissonance. I knew she was terminal but she always came back so the 2 didn’t sync and honestly still don’t.
    I’m not grieving the way I expected. She was my whole world, my best friend and last surviving family. I have been busy since her passing arranging her funeral, then there was Christmas, then all of the paperwork that goes along with the death of a loved one and now we’re moving so I am packing and planning so I feel like I’m in denial and protecting myself because the pain is too much to bear. When I do let myself think about never seeing her again I can’t handle it so I change course. I know this is not healthy but I’m still in shock and denial. I fear when the reality actually sets in but thank you for explaining that I am not alone.

  3. Angela  March 1, 2024 at 10:40 pm Reply

    “The paradoxical grief of anticipated sudden death.”

    Yes.

    I wish I didn’t understand this type of grief. But I intimately do. Thank you for naming it and acknowledging how awful it is. Experiencing directly contradictory emotions, like anticipation and shock, is so challenging, confusing, and exhausting. I experienced this with the death of my 38 year old husband from suicide 5 1/2 years ago. And I am now experiencing it again after the recent death of my 17 year old son from suicide. I knew both of their deaths were coming but I could not stop them. No one else felt as strongly as me that they were going to die. Many people denied it. It devastates me. And it makes the pain so much worse. So complicated. So awful. Absolutely and completely soul shattering.

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  4. Tammy Sigmon Moore  February 22, 2024 at 8:01 pm Reply

    My brother was diagnosed with ALS so since there is currently no cure, I began grieving at the time of his diagnosis. He was my only sibling and my first best friend. 1 year later , completely paralyzed and on a bipap breathing machine 24/7, he was still doing ok and death still seemed a way off. We watched a movie the night before and had a wonderful heart to heart conversation. The next morning he awoke and went through his morning stretches when, suddenly he was unable to breathe and sadly and unfortunately he passed away. It is believed he threw a clot. The shock and disbelief that he passed away so suddenly was almost unbearable. We thought we had more time to love on him and keep him with us. 8 months later and it is still shocking and the grief is still practically unbearable. Thank you for bringing to light this type of grief. It validates the feelings since people actually have said that we knew he was terminal. Yes we did, but it was still unexpected at that time when he was doing as well as was expected.

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  5. Cynthia  February 22, 2024 at 6:12 pm Reply

    Another place Anticipated Sudden Death shows up is with Medically Assisted Deaths. And this term “paradoxical grief” perfectly describes the experience of helping someone that you love, to die.

    I can’t count how many times I’ve heard a loved one say something along the lines of “You can both prepare for the possibility of a death while also having that death be completely shocking and sudden when it arrives.”

  6. Rick  February 19, 2024 at 2:14 pm Reply

    Our 23-yr old son was diagnosed with stage 3 melanoma in February, 2021. He fought it for 900 days, then died at 26 on July 23, 2024 in our home, where he was in hospice for his last 10 days. He left a wife of 2 years, a brother, a mother and me, his Dad. He was a kind and loving husband, a beloved son and brother and a gifted athlete.

    From the beginning, I had to learn how to carry the near-certainty of his death (over 90% mortality) yet hold to any hope I could. No one knows how to do this. If anyone says they do, they don’t. If anyone tells you how to do it different, they’re projecting their fear onto you. Be kind, but don’t let them near you again.

    Caleb’s cancer progressed slowly, until it didn’t. Immunotherapy, targeted drugs, radiation – then the cancer spread to his spine and his brain, then two serious strokes. His last two months were cruel and gruesome – two spine surgeries, two brain surgeries – loss of cognition and speech… only a monster would create such suffering.

    I feel zero guilt over the “paradox” of knowing our son would die while hoping he wouldn’t (a clinical trial, a miracle?). What else could anyone do? If hoping, praying, begging, bargaining or rage could have saved him, I would gladly do all of these forever. But that’s not how reality works. Reality makes no deals, no matter how much you hope.

    My compassion and empathy to anyone here who knows what this is like.

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  7. Mark Bailey  February 6, 2024 at 2:33 pm Reply

    This article really helped me. I cared for my mum for nearly seven years with developing Dementia and physical frailty. So at one level I anticipated her death and felt the guilt. However mum died from heart failure all over in a shocking two days in a COVID ravaged hospital. That was the shock. Until now I have struggled to understand the contradiction and yes I thought there must be something wrong with me. Further not helped by COVID restrictions, a pathetic COVID restricted funeral, months on my own with my grief and a house full of caring equipment and memories. At least now I know I am not going mad. Thank you but I am still unsure how to deal with the resulting contradictory feelings three years on.

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  8. Rhyl  February 5, 2024 at 8:30 pm Reply

    This captures so perfectly what so many people couldn’t understand when my daughter died. She lived with cystic fibrosis, diagnosed at just 6 weeks, so anticipatory grief was a constant throughout her whole life.

    Yet she lived an amazing, full life, travelling to 38 countries, completing a degree and diploma and starting another degree, working full time and even getting married.

    When her health suddenly plummeted as a result of catching glandular fever (mono) we thought she’d beat it, just as she had every other infection in the past. When that didn’t happen and she needed a double lung transplant, we were shocked, but expected her life to return to “normal” following the transplant.

    And it did, for two short months, before infection took over. Even then, we couldn’t believe that she wouldn’t beat it. When she died, after a roller coaster of improvements and deterioration for two months, I was SHOCKED!

    Yet someone said to me “Well at least you always knew she was going to die. Not like my friend who’s daughter was killed in a skiing accident”.

    Thank you for validating the enormous shock of her death, in spite of 25 years of anticipatory grief.

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  9. Susan  February 3, 2024 at 5:03 pm Reply

    Last week I read a letter in this column from a woman, US citizen living in another country where assisted death is legal.

    She was feeling guilty because she had cooperated with her husband’s doctor in helping her husband die as he requested.

    My husband died in May. We also were/are US citizens living in a country where assisted death is a right. I miss my husband dearly but I feel I gave him a precious gift by helping him die with dignity and without pain.

    I hope the writer sees this and is able to have compassion for herself and put the guilt for her action aside.

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  10. Greg Mahney  January 30, 2024 at 8:35 am Reply

    Thanks for the article and the podcast episode.

    The idea certainly resonated with me. On our first date a girl, Trenna, told me she had Marfan Syndrome and was likely to die in the next few years, we married the next year and ended up having nearly 33 years together. For the last few years she had heart and lung failure and we knew she didn’t have long, but didn’t know how long.

    Then she had some ill health, she went to hospital for what we thought would be a few days, and …

    That was three years ago and of course I miss her every day. For me it works to write about her and her many fascinating stories in a website named after her. The Guardian newspaper even took up the story of the first date that didn’t deter me, which made me happy.

    Keep talking about your stories, it is a good thing

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  11. David L  January 25, 2024 at 12:25 pm Reply

    Another helpful contribution, as has been confirmed by the above comments. A phrase that came up recently in our family (though not in a grief context) is “I’m shocked, but not surprised.” That seems to express what so many have experienced. You have been shocked by the death of your loved one but not surprised that it happened. These two can and coexist, and when they do, they add more layers to the grief.

    BTW I am a retired psychotherapist with a grief and traumatic loss specialty. WYG is one of very few resources I recommended for my clients.

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  12. Gil H  January 24, 2024 at 12:06 pm Reply

    Litsa, your brilliant piece has inspired me to share the main ideas you outline in it with my two nephews and niece whose father (my brother) is on the last stages of Alzheimer’s disease. I think it would be very useful to have an open discussion about our feelings concerning their father’s/my brother’s decline. Thanks so much for raising the issue.

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  13. Sandra  January 22, 2024 at 12:56 pm Reply

    Thank you for this article. Now my experience with the loss of my husband last year has a name. He was diagnosed with stage 4 pancreatic cancer during a planned surgery for something else. Within 2 months he was gone. I had anticipatory grief from the beginning but several months after his death I was steamrolled by his loss/shock. I have new understanding of the term “shellshock”.

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  14. Ruth Cramer  January 22, 2024 at 12:07 pm Reply

    Thank you for this wonderful article! My husband of 40 years had many health issues, all of which were exacerbated by alcohol and drug abuse. I expected “the call” over a 20-year period every time he was late, admitted to the hospital, or experienced the pain and limitations of his various conditions. I would note how he could no longer do things that had been possible a year prior and often wondered where he would be the following year. His first heart attack was his last and as he died in front of my eyes, I felt that I had mentally prepared myself many times for that moment. I am grateful that he is no longer in pain and that I was present when he died. I had been out of town the week before and still shudder at how he could have died alone. WYG has been the best resource throughout this journey.

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  15. Laurie  January 22, 2024 at 3:56 am Reply

    I feel I lost my husband three times. He had a sudden psychotic break, which was triggered by a flu shot, and which turned out to be Lewy body dementia with Parkinson’s. I never got to say goodbye. I had kissed him goodnight and two hours later, he woke up in full-blown psychosis, and never recovered. He lived for four years, however, and I had to watch him deteriorate physically and mentally. He was just beginning to choke on his food, and I was having to feed him smoothies and thicken his water when one of the caregivers brought in Covid and he caught it, and a month later he was dead. I thought he probably had a year left to live. So I lost him quickly, then slowly, then quickly. It’s been a little over two years and I’m still not sure that I believe it. I have one family member left: my older sister. She suffers from lupus and Alzheimer’s and now I have to watch her go down the dementia path. I admit that I’m scared. I have no support system where I live and I’ve even thought of moving back to the state I grew up in where all my friends are and leaving her here. She does have a son-in-law and his sister-in-law is her caregiver and she comes twice a week, but I think she’s going to end up in a facility. I won’t go into the whole story because it would be too long, but I only saw her one time last year. And I lost my only niece and my dad within a year of my husband‘s death. I read so many people’s stories, and they’re just heartbreaking and I wish there were something we could do. I’m getting counseling, but nothing seems to help. I feel like this is going to defeat me. I wish we could all meet in person and give each other a big hug because it’s too difficult to do this alone. My heart goes out to everyone here and everywhere who is experiencing grief , and basically I guess that’s everyone in the whole world eventually. 😪

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    • Nancy  January 22, 2024 at 7:22 pm Reply

      I’m sending you a big hug as far as I can. Remember that you are important and that you are loved.

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  16. Melissa  January 21, 2024 at 8:30 pm Reply

    Thank you so much, Litsa. That has definitely been my experience. My sister was diagnosed with melanoma in early 2020. One spot, no metastasis. Had the spot removed, was put on a cancer drug for a year. One year later, all good. 3,6 months later, still good. 9 months later (Dec 2021) another spot near the original. Another surgery. Found metastasis in the new year. Radiation for 6 weeks which ended just before an Easter. We all had so much hope. Mid-May ‘21, scan found it in several organs. She also had MS so had to come off that medication. When they did the baseline MRI, they found metastasis in the brain. Immunotherapy was to be the plan but the brain tumours put a wrench in it. More radiation in early June. I shaved her head the last weekend of June because she was losing her beautiful red hair. When I saw her that day, I knew she was dying. I just didn’t know how soon. 5 days later she woke up with the worst headache of her life and hours later she went into shock in hospital as the brain stem was too inflamed. She was put on life support. My brother-in-law had me talk to the doctor – essentially so much inflammation that she was experiencing brain death. “No coming back from this,” she said. The only thing we were all grateful for in the moment was it wasn’t closed visitor covid protocols anymore and we could be with my sister when we took her off life support the next day. Days before her 50th birthday. Definitely shocked it went that way. She was just starting to reveal to extended family she had cancer. My parents were still hoping for a miracle until the last. We always think we have more time. I grieve for all of us here and appreciate the guidance and support of the newsletter and the community.

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  17. Michelle  January 21, 2024 at 6:50 pm Reply

    Thank you for this, as soon as I started reading I thought ahh maybe this terminology will help me better explain the complexities of my grief to others.
    My son died aged 23 October 2020.
    His mental health had been deteriorating for a few years and he started self medicating with cannabis, which only accelerated his ilness. He would alternate from believing he was invincible and couldn’t die, to that he must die as he had a mission to save people and reach the next realm. He was in the early stages of schizophrenia which my father also has.
    I tried desperately to get proffesional help. However, the help came too late, he was now living with psychosis and now totally convinced that he had to Sacrifice himself to save others. I was desperately trying to save him, but I knew the inevitable was going to happen. Just when I thought there was hope of him getting better after he was sectioned and taken to a ‘secure’ psychiatric hospital.. Unfortunately, that’s when it happened. He managed to easily escape through secure doors by following an incompetent member of staff who didn’t notice him. My Son then took him self to the train tracks and walked in front of a speeding train 😭. His inquest concluded he didn’t have the mental capacity to make the choice to live or die as he was in midst of a psychotic episode, he died as a result of mental illness and negligence from the hospital where he was meant to have been treated and cared for. His reality was warped.
    He had been saying to me for the last few weeks of his life ” Mum, I don’t belong on this plane anymore more, I am needed else where”. Every time he left the house I was in fear that he would exit this world.
    So when I got the call he had absconded from the hospital I knew it was coming, I told the police, but due to frequent absconsions from this particular NHS trust hospital, i was told ” not another one” and they put him medium risk non priority and didn’t search the railways or alert the British transport police. I tried to find him my self but I couldn’t find him in time.
    Knowing deep down he was going to die certainly didn’t make the pain any less. I was still in shock and it was still a sudden and violent death that I will never get over. The only saving grace is I know my little boy is no longer In pain and suffering.
    I think many family members who have lost loved ones who were suffering with severe mental health issues and suicidal ideation. Will be experiencing this Paradoxical Grief too. My heart goes out to you all, and to all the dear souls who have departed this way.

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    • Jan  February 12, 2024 at 7:54 pm Reply

      “Anticipated Sudden Death”… This title really piqued my interest to read the article and it hit the nail on the head with my husband’s situation who passed in June ‘23. He had been fighting metastatic throat cancer to his lungs for 6 1/2 years. And when I say fighting, I mean he was never not going through some kind of treatment.. Surgery, radiation, 6 different kinds of chemo, several different kinds of immunotherapy…. A lot. However, he was NEVER without hope… And often some people say it’s the hope that keeps us alive. He was a fighter like I’d never seen and even when doctor’s suggested Hospice towards the end, he said no as he wanted to still fight for his life.

      We were enjoying concerts and short vacations and trips to see family and friends when he was on a ‘good’ streak, but finally when the last chemo’s side effects did more to harm him than the chemo helped, he went into ‘wasting’ and there was nothing I could do to get and keep weight on him – he withered away before my eyes. The weekend before he passed, he was admitted to the hospital for dehydration and between the fluids and blood transfusions, he was discharged and looked better and felt better than he had in months. We had such hope that we’d get several more months together.. Then 3 days later as he was going through palliative radiation to ease the pain in his lung, he was admitted to the hospital for multi-organ failure.

      When the doctors asked me if I wanted to put him on ‘comfort care’, I said of course I wanted him to be comfortable, not knowing that ‘comfort care’ was end of life care in the hospital which meant I would lose him within a day or so. It wasn’t until my sister (a trauma nurse) explained to me what it meant that I fully grasped the direness of the situation. He had rallied so hard just a few days earlier, I was shocked that this was happening.

      His last words to me were, ‘I guess I’m throwing in the towel, then?” And he asked if he was going to die. I just couldn’t answer him. He just never wanted to give up. I was in shock when he passed less than a day after he was admitted… even though I witnessed his weight loss and health decline every day. But I think the good days in between always gave both of us hope.. And music.. When he could listen to music, his spirits always lifted and he could take his mind off of the cancer that was taking his life. I have so much guilt and ‘woulda, coulda, shoulda’ thoughts around the experience and his care and what could I have done better or differently and people don’t understand my shock even now. I just miss him..

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  18. Kathy  January 21, 2024 at 2:48 pm Reply

    Litsa,

    Thank you for another beautifully crafted article. You articulate so well what many of us feel and cannot name. Paradoxical Grief feels like the next category for us to name and explore.
    I feel like I’m sitting in this space as I watch my brother decline from his GBM diagnosis. Surfing the waves, which occasionally bring hope, brings us crashing down more often. I’m realizing how I’m also thrust back into the grief of our mother-loss early in childhood.
    I’m aware of the decline of a dear friend, and while I try to “prepare” intellectually, I know it will still have elements of shock.
    As someone who works in the field of grief, I also know I have no immunity toward feelings. Some days they feel closer than ever.
    Thank you for offering me and my clients another way to discuss grief and create more space for its many faces.

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  19. Donna  January 21, 2024 at 2:14 pm Reply

    When I tell people that my husband’s death was sudden and unexpected, I tend to hesitate— as if I’m not telling the truth. But it is MY truth. Yes, he was an older man; yes, he had just been diagnosed with cancer. But from illness to death was only two months, there was no history of cancer in his family, and he’d been vigorous and healthy. So when I say his death was “unexpected,” I guess I mean that ALL of it was: the symptoms, the illness, the diagnosis, the decline, and his passing. Maybe I was just in denial. But whatever it was, it still felt sudden and I am still in shock.

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  20. Barbara+Kalis  January 21, 2024 at 12:53 pm Reply

    I always read the articles and try to find help for my grief. My husband died last April from terminal brain cancer. It was anticipatory grief knowing that he would not survive this. But I haven’t seen addressed the grief associated with an assisted death. For me having a doctor help my husband die, at home, and relieve him from suffering his loss of everything that made him him, was simultaneously a relief that he had his wish fulfilled, to die, and deep-seated grief at his passing. I address daily the grief of losing him and now I am finally admitting, the pain of helping him die. Could you please address this? As an aside I do not live in the USA although I am a US citizen. There are no grief counselors that I have been able to find where I live so I find myself talking to close friends who have experienced the loss of a spouse but no one who helped their spouse die, and thus don’t have this extra burden in their grief.

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  21. Margaret  January 21, 2024 at 12:42 pm Reply

    After my husband of 45 years died in 2021 of a heart attack, I came up with the term “grelief”. Grief + relief. The 20 previous years were fraught with ambulance trips to many different hospitals, complicated surgeries, diabetic wound care regimens, and a calendar full of specialists’ appointments. He had excellent care at every turn, but I often found myself struggling to be the cheerleader on the sidelines. It was exhausting mentally and emotionally. I was also dealing with my father’s decline into the Alzheimer’s abyss and his struggle with bladder cancer, and I left my husband in the Cleveland Clinic to pre-arrange Dad’s funeral in case HE died while I was in Ohio. I’m still dealing with guilt that I was in New York when Gene’s heart attack happened. It wouldn’t have mattered if I’d been there, or so they told me. So my relief that it was over for him was mixed with guilt and grief. Still is.

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  22. Sandra  January 21, 2024 at 12:32 pm Reply

    A brilliantly crafted piece.
    It perfectly describes what happened to our family, my husband was diagnosed with terminal cancer, in 2021 after twelve month’s his treatment (which was mainly to try to slow the growth and spread of the cancer) was stopped as the cancer was now rapidly spreading through his abdominal lining.
    We were told “time is short” but he still looked unbelievably well and was also able to get out walking our dog and was reasonably active.
    Then two months later he was suddenly admitted to hospital and passed away three days later due to a bilateral pulmonary embolism.
    We were stunned, although we had “anticipated “ his death for several months the shock of losing him so “suddenly “ has been very very painful to accept and we struggle to deal with this on a daily basis. Your article has helped me understand the mixed emotions and pain that his “anticipated but sudden” death have brought. Thank you so much.

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  23. Shana  January 21, 2024 at 11:57 am Reply

    I really appreciate this article about paradoxical grief. We have also experienced this kind of loss more than once in our family. It has been excruciating, in part I think because they have been living with serious illness and we as a family have done our best to give them support, including being their advocate as they navigate the medical world.

    You have raised the importance of recognising the shock and disbelief that comes following the loss of someone who has been battling a long term illness, or is of advanced age. These factors do not lessen our feelings of loss and the deep grief we experience. Indeed, their sudden death, without closure, has left us with a great sense of yearning.

    From the outside, it is assumed by some, that somehow we must be less surprised, and therefore we will grieve less, or differently. In my experience, these losses have been enormous and very painful. I miss them dearly and their absence is felt deeply. My love for them lives inside of us. We do our best to honour them in the way we live. Thanks again for naming this kind of grief.

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  24. Maria  January 21, 2024 at 10:36 am Reply

    Paradoxal grief seems a very appropriate term. Watching my husband disintegrate daily into the depths of early onset Alzheimer’s, drove me to a place I have never been before, could never anticipate being in, and almost didn’t survive. And I knew where it ended, as we all know when someone is terminally ill, but was still Surprised when the call came. It was a surprise as though it couldn’t happen, although I prayed for it to happen so that suffering would be minimized. 10 months later, I’m still deep in the throes of grief, what it does to me surprising me at every turn. Grappling with the thought of never being myself again.

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    • Deborah C  January 21, 2024 at 1:15 pm Reply

      I’m very sorry, Maria. It’s very recent for you. My precious husband passed away 2 1/2 years ago. I can say from my experience that you may never be yourself again. You are a version of yourself but deep down inside you’re still “you “, just not the “you” you were used to. Even as time goes on I know I’ll never be who I was before.
      The only thing I can say is be patient with yourself. There’s no right or wrong way to walk through this. Lean on those close to you. Take care.

      • Sandra  February 2, 2024 at 1:15 pm

        Agreed, we are changed by the loss of a dear loved one – we are the same but a different version of ourselves as we navigate grief, a constant evolution where we must be kind and patient with ourselves.

  25. Janet Bartow  January 21, 2024 at 10:02 am Reply

    I lost my beloved husband 3 1/2 years ago. He was battling lung cancer, and although we always knew that it it would likely be what took his life, he was getting better. Scans were clean, he had recovered from his radiation therapy side effects and we were hopefully entering the next phase of immunotherapy. We were such a team and closer than ever.

    His body reacted to the medication, and he developed severe inflammation in his lungs that he would not recover from. He entered the hospital and I watched him slip away over the next 18 days. It was devastating, and I know the experience has changed me forever.

    Appreciate the discussion around paradoxical grief – it feels like it fits. Very similar to the story about your dad.

    I have experienced every range of emotion and feeling – and have often recognized that our hopes were lifted with good news only to be dashed by the effects of something that was supposed to prolong his life. I do know this has made my grief journey more difficult. I try to enjoy the good in every day, focus on the happy times and live a good life.

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    • Sandra  January 26, 2024 at 5:06 pm Reply

      Your experience sounds very much like mine, my husband was diagnosed in 2021 with inoperable cancer, his first cycle of combined chemotherapy and immunotherapy resulted in a severe reaction of hepatitis which meant he didn’t have any further treatment for over three months. And like you our hopes were raised and then dashed numerous times. He then had a few more treatments until May 2022 when he again reacted with a severe pneumonitis. He died suddenly of a pulmonary embolism, I wasn’t even with him and I will never get over the shock of losing him so suddenly even though we had been told he only had months left. This article has helped in a small way to reassure me that my feelings are totally natural. And knowing others are feeling the same is also important.

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  26. Jacqueline  January 21, 2024 at 9:59 am Reply

    I found this very helpful. Thank you so much .

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  27. Deborah Collins  January 21, 2024 at 9:53 am Reply

    Oh my goodness. I’ve experienced this with my amazing husband’s death. He was diagnosed with cancer and the doctor told us to expect 3-5 years with aggressive treatment. My husband had an entire year of chemo and suddenly passed away in the hospital after one year. It was shocking to me and what’s left of my family.
    Thank you for putting a name to it and more importantly discussing it so that I don’t feel so alone in this phenomenon.

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  28. Penny  January 21, 2024 at 9:52 am Reply

    Litsa, thank you for this article as paradoxical and anticipatory grief are the perfect description of what I felt before my daughter died in 2020. I lived with the dread of something happening to her for quite some time due to her reckless lifestyle including prescription medication addiction. I’m not a fan of labels but in this case I embrace them.

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  29. Diane Koosed  January 21, 2024 at 9:48 am Reply

    Very helpful for me, as this was my situation. I’m glad to have a name and description for it. Thank you so much, too, for sharing painful situations from your own experience.

    Another paradox I experience is this: I am fine living alone; in fact, I like it quite a bit, the first time I’ve experienced it in my 70 years! At the same time, I miss my husband greatly. Seems somewhat oxymoronic. I guess paradoxical is a better way to put it.

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    • Ann G  January 21, 2024 at 1:47 pm Reply

      Similar story here. I never knew there was a term or description of what I’ve experienced. Married 55 years to my best friend. Since 1995 when he had his first of many medical issues I have been dreading the next one to come along. Last year he finally succumbed to congestive heart failure and it was such a shock since he’d been close to death so many times and had always pulled through.

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    • Trish  January 22, 2024 at 1:14 pm Reply

      I understand the ‘like living on my own’ part; I do, too. I loved my hubby with all my heart and still grieve and miss him the same way. But, after 7 years, I am enjoying my independence very much and have no desire to go through that again. ❤️

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  30. JaneC  January 21, 2024 at 9:29 am Reply

    I lost my mother of 89 years end of November – almost 2 months ago, and this article is so what I’m in right now. I had 3 months of nursing my mum as she declined and became bed bound, after 18 months of ongoing illness and my increasing support. When mum passed I was and am still now shocked and confused (strangly as I knew it was inevitable!). Your articles are so enlightening and I do so often find them a comfort. Thank you.

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  31. Gael Y  January 21, 2024 at 9:09 am Reply

    Paradoxical grief – this article describes exactly what happened when my husband died.

    He got the “inoperable and terminal” diagnosis in December 2016, and died at the end of March 2018.

    Through those 16 months I lived two separate lives. One side of me walked alongside Jeff toward death. We were filled with hope, as I think many people in that situation are. A belief that miracles can happen, so maybe it will happen to us. A trust that death won’t come until it truly is time. A sense that Jeff had more agency over whether he lived or died, and thus he put his entire willpower toward living for me and our two children.

    This is why cancer is a fight. Because it takes energy and determination to keep going. and that was working, in a way.

    The other side of me was preparing for a life without Jeff. Securing a job that would provide enough for the remaining three of us, which meant moving our entire family to a new community 2 hours a way as jobs with a sufficient single income were not available locally. Finding a home.

    Alone in the car or shower I cried so much every day, as I tried not to talk too much to Jeff about my preparations for a life without him, as I tried not to talk too much about the death I was anticipating to new coworkers. I cried so much, I was convinced I was doing all my grieving. I was so wrong.

    So strong I was able to walk with one foot in Mordor, in the land of hospitals, treatments, hospice and death, and the other foot in starting a career and building a future. So weak I had no defenses when the emotions overtook me in the car or shower.

    When Jeff did die, I was shocked to the core. He was always so vibrantly present that I felt like he was no closer to death than I was. I didn’t realize that was partly an illusion created by walking alongside him as close to the edge of that cliff we call death as possible.

    Death of a spouse is like one piece of fabric (woven together as you build your life together), getting ripped in two. Anyone who sews knows – to rip fabric takes force and speed. Yes, I knew he was going to die. And yes, it was incredibly sudden and shocking when he died.

    I have spoken to others about how grief is like working down that ragged tear and figuring out what to do with each of the dangling threads – which ones can be woven back into what’s left in a gentle way, and which ones end with such an abrupt, brutal chop that you have to leave them exposed.

    What I haven’t talked about is that other part of me. The part that walked alongside Jeff into Mordor. That witnessed horrors with him. That held his hand and offered my hope when his was fading. The part of me that believes in miracles (that still does), and believed it could happen to us.

    I had to find a way to stop that part of me from reflexively walking on toward death. Which meant I had to stop believing Jeff could beat the cancer, I had to let go of that hope. But not let go of the belief in miracles or hope in general, because those I needed to carry out of Mordor with me, to have in my life and share with my kids.

    I had to turn that part of me around, and make that part of me walk away from death, which meant walking away from the last place I saw Jeff. Which meant, in some ways, walking away from Jeff.

    And I had to walk out of Mordor alone. No fellowship of the rings group showing up to magically escort me home. No, because most people don’t realize how far you can walk toward death with your spouse, how far you can go emotionally and psychologically. They don’t know where you are. They can’t find you. And nobody has any idea of the route home.

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    • Trish  January 22, 2024 at 1:30 pm Reply

      What you have written has struck me to my core. Tolkein fan here, too, and ‘walking into Mordor’ with your husband and then feeling abandoned there is exactly what it felt like for me. Fighting the urge to stay and finding your own way out of there and back to your new life describes it perfectly. My soul was ripped in half when he left. (That is almost impossible to explain to others who haven’t been through this.) I thought I was doing my grieving ahead of that day, too. Boy was I mistaken. An entirely new kind of grief began that morning. “I would rather spend one day with you than a lifetime alone.” ❤️

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  32. Nancy N  January 21, 2024 at 9:00 am Reply

    Paradoxical Grief names precisely what I experienced in my daughter’s death from a brain tumour (GBM). She was in palliative care. Weeks of “waiting” but being “hopeful”, followed by a sudden and traumatic death. It will be on my mind forever. Thanks for naming my experience to a “T”.

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  33. Mollyrose Dumm  January 21, 2024 at 8:58 am Reply

    Thank you for this. The timing could not be more perfect. My brother in law has a genetic mutation that essentially prohibits his body from recognizing cancer as an enemy and he’s had over ten toes of cancer since he was an infant. The fact that he’s made it to 40 is nothing short of amazing. He was just recently told there are no more options and is entering hospice. Though we’ve all been prepared to hear that literally his whole life, we are floored. It’s finally here. Thanks for giving this crap feeling that’s been making me feel like a crazy person a name 💜

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  34. Wanda  January 21, 2024 at 8:51 am Reply

    I think I experienced various named griefs with my husband. He had various medical issues, and I have been called in many times saying there was no hope so anticipatory grief for sure, and after reading your article paradox seemed to apply. I know sometimes while caring for him I would think would today’s the day widow, and then belittle myself for having that thought.
    When he did pass, I just gotten back from the hospital and they called me and then I was shocked and then in a daze for months.

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  35. Stacey  January 21, 2024 at 8:44 am Reply

    I can certainly relate and appreciate that there are extra layers to this grief. Our mom got sick with Covid in Dec 22 which turned into pneumonia. Because she had MS, she wasn’t not able to fight off the rapid decline in her lungs. We fought the good fight for three weeks. She literally went in with a cough and maybe what we thought was the flu and unfortunately lost her several weeks later at 72 years young. Though she had a MS, that never stopped her and you would never tell. But this was just an absolute shock. She actually passed on January 20, 2023 so it’s quite timely that I read this article on the one year anniversary – still in shock. I feel all the feelings you expressed with all of those layers of emotion.

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  36. Daniel Janich  January 20, 2024 at 8:36 pm Reply

    Litsa, thank you for posting about paradoxical grief. I totally relate to it, conflating anticipation with “giving up.” You don’t and won’t give up even when reality is staring you in the face. The subsequent loss is a shock that others will never fully understand. Before your loss your brain wanted to protect you from an emotional downfall that–in hindsight–you realize was inevitable. And when it happens, the shock is even harder.

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    • Gael Y  January 22, 2024 at 1:48 pm Reply

      Very succinct Daniel. And very true.

    • Trish  January 22, 2024 at 4:19 pm Reply

      My husband’s and my close friend accused me of “giving up” and “not praying hard enough” (whatever that means!) when Paul was fading fast. That cut like a knife and it still hurts. You all know that I/we had not given up hope, but that we were also having to be realistic and deal with the reality of what was coming. I don’t think she could see or understand that. But it hurt both of us. And I agree with all of you: lots of crying in the car, walking the dog and out of his sight. I’ve never felt so alone and abandoned as when he died that morning.

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      • Gael Y  January 29, 2024 at 6:52 am

        That hurts to read Trish. (((Hugs)))

        Judgers are going to judge. One of my friends visited when my husband was still at home, bedridden, in a hospital bed in our living room. She dumped me as a friend after – disgusted with me for giving him “false hope” instead of pragmatically stating the obvious (he’s dying). Really? How often do you think he needs to hear that?

        There is a massive chasm between our lived dual reality (hope and pragmatism), and what people expect of us. They just. don’t. get. it. And if they’re the judgmental type. Their lack of comprehension/empathy, is going to be projected out and onto us, as something wrong with us. Very hurtful and infuriating.

      • Rick  February 19, 2024 at 1:10 pm

        Hello Ma’am: Having lost our 26-yr old son to melanoma, I know what an unthinkable dilemma you faced. Holding the near-inevitability of death while, at the same time, grasping at any good or even “not-bad” results to help you hold on to hope.

        No other person has the right to comment on what you should do or feel, no matter what framework (religion, prayer, positivity, etc.) they’re coming from. Your loss is yours, as is your journey into and, hopefully, out of grief.

        Try to recognize that comments like these are a projection of the other’s fears of the same thing happening to them.

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