... And Death Comes Home
by William G. Hoy
This issue comes with an entirely different “feel” because I am now living a very different life; on February 16, my world changed. After picking up a couple who had been friends of my wife for 45 years and friends of mine for a decade, I was rear-ended by a speeding 18-wheeler on I-35 in Waco. I had slowed to a near stop; the truck driver did not. His truck hit us nearly square-on at freeway speed, sending my car into a 360° spin, broadsiding two more stopped vehicles, and coming to rest 50’ from the impact.
Golden Parsons, the wife of our couple-friends, was seated in the backseat of my car and was killed on impact as the back of the car was literally pushed into the passenger compartment. Her husband, Blaine, and I were transported to our nearest hospital. My injuries turned out to be more serious than I first allowed myself to believe including abrasions, cuts, bruises, a moderate concussion, and a compression fracture in my back. I have gone from just using a staple in my papers to having one in my head. Fortunately, the newly repaired hip seems to have escaped any structural damage.
In a nanosecond, I went from counselor to the traumatized bereaved to the traumatized bereaved patient. Since we began publishing this newsletter nearly 15 years ago, this is the first time I have had significant help actually writing my column (thank you Debbie and Molly). The effects of the concussion I sustained in the crash are creating all kinds of spelling and syntax errors in my writing.
Writing this one week later at the same hour of the crash, I know it is far too early to be making meaning or explaining how this will impact the rest of my life and career. Because I have always tried to be open with readers about my own “stuff” in caring for the dying and bereaved, I could think of nothing more appropriate this month than to provide a “progress report” on where I am now.
I am broken and sad but not hopeless. Like every reader of this column, I know that being a clinician does not give me a “pass” on doing the hard work of processing trauma and loss; I must face and muddle through the same complexity of emotions, spiritual questions, and cognitive tasks as any other individual who has been traumatically bereaved. Without a doubt, this is the single most devastating experience of my nearly 56 years on the planet. My training and my experience tell me that I will eventually integrate this trauma and loss experience into my life. My deep and resonant faith provides hope even in the darkest nights.
Professional help is good even for the professional. When I awakened tearful and afraid in the wee hours of Sunday morning three days after the crash, my words to Debbie were simple, “Can you call Helen and have her come?” Dr. Helen Harris and my long-time friend Dr. Louis Gamino, two clinicians par excellence have been helpful beyond measure. Most of the things they (and dozens of other colleagues) have told me have generally been principles I already knew. Hearing principles spoken with care exudes a power and an influence all its own. Debbie and I could not get through this without these faithful friends who have so willingly stepped up.
Physical injury complicates trauma processing. I do not know that I ever gave full credence to the influence serious injury has on the cognitive and emotional energy available to process trauma and loss. REM sleep is vital for trauma processing. Between the nightmares and the pain that has been, at times, simply otherworldly, there is not much left over for the hard work of memory consolidation and grieving. We have to be extra patient with our patients/clients who are physically injured as well as traumatized and bereaved, and I suspect I have not factored this into my care of patients nearly well enough. Thankfully, Louis, Helen, and the legion of others are helping us understand this truth.
My faith is strong but I still have questions. Most who have heard me speak or read my work would conclude faith is important to me. I do not blame God for this tragedy; God was not driving the truck. But do not offer me spiritual platitudes about how God is in charge and all things happen for a reason and it was just Golden’s time. I do not doubt God’s faithfulness but I must admit I wonder about God’s timing. At 75, Golden had a profound and continuing influence on the world (evidenced by the 700 people at her funeral). Moreover, she was the primary caregiver to her husband in the middle phases of Alzheimer’s disease.
The depth of my faith could be one reason I find such resonance with the lamentations of the Jewish Bible and Christian Old Testament. The psalms of lament (like Psalm 13 and 79) and the book called Lamentations belonging to the Hebrew prophetic books tell my story. During the period I call the “night watch” when concussion insomnia tends to have me awake for a couple of hours every night, I wrote these words (with some daytime editing help of course!) on night seven of this experience:
What does it mean to trust God in the interval—the interval between question and answer, or at least between question and redemption? I suppose it means to keep reading and meditating on scripture, it means continuing to practice Sabbath through corporate worship and community connection. It means to seek God’s face in prayer, not as a remedy to my problem but as a shaper of my spiritual character. It means to give to others at least as generously as I have received and to continually assure our use of resources is aligned with God’s purposes, seeing ourselves as stewards and not owners. Then I can echo the prophet of Lamentations: “This I will call to mind and therefore have hope. The Lord’s lovingkindnesses indeed never cease, for His compassions never fail. They are new every morning. Great is Your faithfulness O LORD (Lamentations 3: 21-23).
Remember that trauma and grief are not the same. More than 20 years ago, I first heard my mentor J. William Worden say that trauma was different than grief and we have to attend to the trauma first. How true that is for me. Right now, I am grappling with the typical trauma symptoms of persistent re-experiencing of the event, avoidance, and hyper-vigilance. Until those issues are well in hand, there will be no room for me to work on the loss. However, Debbie’s long relationship with Golden makes her grief palpable now, even as she tries to support me in my experience with trauma.
There is no substitute for community. I do not know how he did it, but before I was even loaded into the ambulance, Bill Neilson, my retired surgeon colleague and best friend at Baylor (my assistant says we have a “bromance”) was standing on I-35; how he got there so quickly is beyond my understanding. From that moment until now, we have never felt alone. The phone has rung regularly and I have learned to use voicemail when I do not have the energy to talk. The good wishes and promises of prayer have come from our own wonderful community of friends and family as well as colleagues around the world.
I am not blind to the possibility of increasing disability. The ability to find the right words, speak coherent sentences, and write prose that informs and inspires is a practiced gift but I think I take it less for granted now. I needed help getting this manuscript written. However, I also know that serious concussions in late middle age have their own potential long-term consequences; I have done this work long enough to know I am not automatically exempt from such effects. For now, we take adaptive action to manage the cognitive symptoms, we pray, we hope, and we wait.
Some things are funny in the midst of misery. In spite of the serious nature of head trauma, there is also a “lighter side.” When my wife returned from Waco this morning, I proudly announced that I had made myself a breakfast of oatmeal and orange juice. To her surprise, when she opened the pantry door, there she found the OJ proudly sitting on the shelf where the oatmeal belongs. You can probably guess what she found when she opened the fridge? The human brain is an amazing creation, even under stress.
So, my friends, this is the beginning of what I anticipate will be a long journey. As death has come home to Debbie and I in a particularly violent way, I am so grateful for my training and experience that points the way to integrating this crisis into the rest of our lives. Moreover, I am reminded that few outside of our community of caregivers will have the benefit of the resources at our disposal so we must redouble our efforts to care well for those who hurt deeply in similar circumstances.
The Author: For more than three decades, William G. Hoy has been counseling with the bereaved, supporting the dying and their families, and teaching colleagues how to provide effective care. After a career in congregation, hospice, and educational resource practice, he now holds a full-time teaching appointment as Clinical Professor of Medical Humanities at Baylor University in Waco, Texas.
So that Dr. Hoy can read get-well wishes as he is able, please send those to Bill.Hoy@outlook.com
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