A THERAPIST GRIEVES
As a young boy, I remember wondering things like, Why does everyone laugh at that kid? Why does my friend’s dad never smile? Why is that boy so mean when that girl is always so nice? A basic curiosity about my fellow humans has always been a part of me. In high school I was also the person that friends (and occasionally teachers!) sought out to share their troubles with. My choice of careers thus seemed preordained.
I graduated with a psychology degree from the University of Texas and went on to earn a master’s in counseling in 1979. My first job at a nonprofit counseling agency in my hometown was the realization of a professional dream.
Psychotherapy was new and cutting edge then, a time when the self-help movement was gathering steam and the stigma of therapy had lessened. New therapeutic interventions were proliferating. Psychodrama, family therapies, hypnosis — bold methods with cathartic outcomes — were exciting new options for clients suffering from anxiety, depression, or troubled relationships.
In those early days, I was particularly drawn to working with children and teens, which really meant working with their families. I would cram parents and siblings into my tiny office and try to help them understand how family dynamics might be contributing to a young person’s suffering. I would gently cajole and provoke couples and children to try to get them to a healthier place. The work was extremely gratifying.
At home, I shared that exhilarating time with Nancy, my college sweetheart. We were married in 1974, and six years later, in the spring of 1980, learned that she was pregnant with our first child. That’s when difficult realities began to intrude on our idyllic young lives.
Nancy, not due to deliver for three months, was awakened one night by a strange physical sensation. She wanted to get it checked out, just to be safe. The next morning — the day after Labor Day, to be exact — we found ourselves sitting in her obstetrician’s office. After the examination, her doctor said we needed to get to the hospital. Labor had begun.
I remember how Nancy’s voice trembled.
“Can a baby this premature live?” she asked.
“I don’t know,” the doctor said. “We will try to buy time. He will be a pipsqueak of a kid.”
Thirty-six hours later, on September 3, 1980, Ryan Palmer O’Malley was born, weighing a little over two pounds. You couldn’t have imagined a more fragile-looking creature. He had been far from ready to leave his mother’s womb, yet there he was. In the first few moments of his life, I was aware of the great risk of loving my son, but I was powerless to resist doing so. From the first glimpse of Ryan, I knew he would have a place in my heart forever.
His early life was a succession of seemingly endless days and nights. We hovered over the side of his crib in the hospital, looking down at our boy who was hooked up to all this noisy equipment. His life was measured in minutes and hours. On several terrifying occasions, Ryan stopped breathing, and his medical team would rush in to resuscitate.
All that time, Nancy and I yearned to hold him, but his frailty and the equipment made it impossible. The most we could do was touch a tiny finger, rub a tiny arm. Instead of cooing, the sounds around my son were the mechanical beeping of intensive-care machines. Instead of that wonderful new baby smell, there was the pungent scent of the antiseptic soap we had to use to scrub up before seeing him. Despite not being able to hold him, despite all the machines between him and us, we loved him deeply.
Early fall turned to Thanksgiving and then to Christmas. Our son gradually grew stronger. One day in January, his doctor weaned him from the respirator. We could finally hold him without the tangle of tubes and wires.
On March 9, 1981, our seventh wedding anniversary, we were finally able to bring our baby home to hold him, bathe him, kiss him, dance with him, feed him, and rock him. He smiled for the first time in those days. Though he was still fragile and underweight, we allowed ourselves to start imagining Ryan’s future. No parents loved a son more.
And then he was gone.
On Saturday night, May 16, 1981, we were treating him for a cold but were not particularly concerned; we had been through much worse. But early Sunday morning, our precious son suddenly stopped breathing. I started CPR. Ryan’s doctor and an ambulance were at our house within minutes. His doctor administered a shot of adrenaline to his heart as the medical technicians continued CPR. Nancy and I silently prayed as we followed the speeding ambulance to the hospital.
The next several hours are a series of snapshots forever imprinted in my mind.
• His physician coming into the waiting room with tears in his eyes, saying, “I could not save him”
• Holding Ryan’s body
• Returning home without him
• The heartbreak of our family and friends as we broke the news of his death
• The dreamlike, adrenaline-fueled rituals of visitation and funeral
• The faces of all those who filled the church
• The sight of his tiny casket by the altar
• Seeing construction workers removing their hard hats as the funeral procession drove by
• Leaving the cemetery on that sunny spring day
In the days after the funeral, Nancy and I disappeared into the mountains of New Mexico.
“We’ve been in a cabin in the mountains for three days,” I wrote in my journal. “Normally a setting like this gives us boundless energy. [Now] we wait for the minutes to pass. We talk incessantly. We talk about him and about all the people involved in his life and in our life. We go over his last hours a hundred times out loud and God knows how many times to ourselves.”
Although I was emotionally numb after Ryan died, I went back to work within a week. My bosses were supportive, and I could have taken more time, as I probably had no business seeing clients in that mental state. But I had no clue what I needed, what I was supposed to do. I was twenty-eight years old, and for all of my training, I had no experience with personal loss.
Some of my clients had heard about what had happened. I accepted their expressions of condolence but quickly tried to turn sessions back to their problems. I was trained to make sure I was taking care of them and not the other way around. But there were some awkward moments. I remember how some clients apologized for talking about their anxiety or unruly adolescents when my tragedy seemed so much worse.
I hope I did passable work, but frankly, I don’t know if I did. I’m sure my attention span was terrible, and I often thought I should have taken another week before returning to my office and clients. Knowing what I know now, I realize at least a full month would have helped. In the weeks after Ryan died, I felt nothing but relief when a session was over and even more relief when the day was done and I no longer had to concentrate.
It was summer when my shock faded and the extent of my heartbreak became clear. I sought refuge in typical “escape” behaviors — “happy” hours and late nights, partying after work with my young colleagues. Yet I couldn’t out-party my loss. One minute I would be jolly and engaging; the next, consumed by sorrow. I remember a couple of times disappearing into the bathroom at parties to weep. I would be out with the guys having a beer and would duck away when I felt the tears coming.
At home, sleepless nights followed one upon the next. I lay in bed, haunted by the memories — Ryan’s first smile, followed by the moment he was driven off in the ambulance. And the questions — always the questions. What if he had lived? What would he be like now? What could we have done differently?
Recently, for the first time in probably twenty years, I reread my journal from that painful period. The words still caused my heart to sink and tears to well. As I reread those pages, I felt great compassion for Nancy and myself, the young couple who had to endure such a loss. We were younger than my two grown sons, Kevan and Connor, are now.
MAY 31, 1981
It has been two weeks. It seems like yesterday, and it seems like forever. Went to church today, and I couldn’t look at the altar without imagining his casket being there. Work wasn’t as bad as I expected. I cried several times Monday, which helped. I guess it is good to pretend to not be miserable. We’ve been out every night. It feels empty around here. Thursday was a very hard day for me. Thursday afternoons were usually “our” time together. So I walked in and went straight to his room and thought I would explode with missing him. I awakened early this morning thinking of two weeks ago. Going over every detail — those scenes are so clear. It’s easier to picture him dead in some ways. It’s so painful to remember him when he felt good and was smiling.
JUNE 6, 1981
One more sleepless night. Will Saturday nights and Sunday mornings be reminders of what I’ve lost forever? If not, then when will the Saturday and Sunday come that I don’t spend most of the hours going over and over those final scenes? The distractions are waning, which means his death is slowly becoming more real. How could he have been smiling so three days before he died?
Ten years ago I was writing thank-you notes to people who were celebrating my high school graduation. Tonight I write thank-yous to people who responded to my son’s death. Growing up doesn’t seem like a good deal tonight. The pain isn’t much better. The emptiness is worse. The nights (and days) are longer. We bought a grave marker two weeks ago. Last week they put down a temporary one with his name on it. Not easy to see his name on the ground over a grave. His name belongs on his door, on his things, on his school papers and artwork.
AUGUST 17, 1981
Three months today. I think of him more often. My high school reunion and a friend’s wedding have come and gone. People asking me how many children I have. One even [told] me how lucky I was I didn’t have any because they are so much trouble. I had imagined the . . . “show off your kids” part of the reunion a hundred times, but I was empty-handed. Surely the proudest day of my life was when I took him to work and so many people saw him. I was so very proud.
NOVEMBER 17, 1981
Six months gone. It’s been long since I’ve written. Not many ask about him lately. Some of those closest to me don’t ask. I wish they would. Those who do, help a great deal. I believe the holidays will be sad without you. Being with other babies is still very sad. I moved my stuff into Ryan’s room tonight. It still seems as though it is your room, although your things are packed away. The smell of your room lingers just a bit. This is my office now, but I’m filled with thoughts of you. Rocking you, changing you, watching you sleep. I’ve put my favorite picture of you and me out. I want to see it every day, although it hurts.
In another journal entry from just a week after Ryan’s death, I wrote: “What ‘stage’ am I in? Still denying, I think. When will I get angry?”
Because of my training as a therapist, those were my expectations of mourning. If I was conscientious about my “grief work,” faced up to the pain, didn’t stuff my feelings, and “let go” of my son, then, I believed, I was destined to achieve emotional resolution. Grief felt like a toxic substance, something foreign that had invaded my body like a fever, something to be expelled. That feeling was consistent with linear models like the stages of grief. It was an illness to be cured, a wound to be healed.
And fight it I would. I would face up to my pain and thus be able get back to my life as before, without the cloud of sadness stalking me day after day. Closure was another word for it. One writer also called it the “psychological finish line.”1
I spent the first anniversary of Ryan’s death at his grave for a profoundly emotional several hours. It was unfathomable to me that his little body was in the ground just a few feet away. I imagined him beginning to walk and talk as a toddler of nearly two, of all the little milestones we would never experience.
I wrote in my journal that day:
The magic year has passed. I am somewhat healed, although when given a few specific thoughts, I feel intense heartache. I walked through the cemetery today and was astonished at the ways people honor the dead. Our acknowledgment of Ryan is most simple. I looked at pictures and read old cards and letters. My memory is incredibly fresh when thinking about the Sunday to Sunday — the week of his death. The rest of the year is fuzzy. Many sleepless nights — that peculiar ringing in my ears when I talk about him for the first time to new acquaintances. Certainly I have thought of him on [each of the] . . . three hundred sixty-five days. I will continue to define our relationship.
I expected relief after that first anniversary, but the second year seemed just as painful. That year, having experienced very little relief from my sadness, I sought out one of my town’s leading therapists. Based on his reputation, I was confident he could help me resolve my grief.
“I keep waiting for closure,” I told him in our first session. “It’s coming up on two years. I expected to be past this by now.”
“It does seem that something is incomplete,” he said. “You haven’t let go of your son.”
“It’s not for lack of trying,” I said.
“We have some work to do here,” he said.
He gestured to an empty chair near us in his office.
“See Ryan there,” he said. “Put your little boy in that chair.”
I squirmed. I had done this exercise with clients and in training, but it was most uncomfortable having the tables turned. I did as I was told.
“Now tell him what he means to you,” the therapist said. “Tell him how much you miss him. Tell him how much you love him.”
I did, sobbing.
“Now tell Ryan this,” he said. “You’ll always love him, but you need to let him go.”
More sobs.
“I’ll always love you, Son, but I need to let you go.”
I was grateful for those tears and the chance to speak my love and yearning for him. By then, I no longer felt comfortable talking about Ryan with friends, and they didn’t ask about him either. It had been months since I had had a cleansing cry. As I spoke to my son in the chair, the internalized emotion came pouring out. The therapist commended me. I had done everything that could be asked of a mourning person.
But that session did not provide the conversion experience I had hoped for. It did not resolve my sadness. Speaking with another in that safe environment, I could touch my sadness, feel it, but it didn’t go away. I lived in a state of confusion. Either there was more work to be done, or I wasn’t doing it the right way.
Nancy became pregnant again a year after Ryan’s death, in the summer of 1982. We lived the next nine months with a knot in our stomachs, but our second son, Kevan, came into the world the picture of health. The anxiety didn’t end there, though. Nancy and I were vigilant in the early months of his life, checking to make sure little Kevan was breathing. But we were also ecstatic, as were our parents, other relatives, and friends. No one was happier than my dad, Bill, who relished his new role as grandfather and occasional babysitter.
From the time I was young, I had sensed a shadow surrounding my father. As I grew older, I learned much more about the great suffering in his life. He had lost both of his parents and his only brother by the time he was twenty-five. He was also the typical Irishman — a mixture of tough and tender, bluster and kindness, a storyteller with a gregarious personality and a great sense of humor.
He was always my biggest fan. It seemed like he never missed a chance to tell me how proud he was of me. It pleased him so much that I was doing work that I loved. He had struggled to find his calling in life and wanted nothing more than for his children to find theirs.
When Nancy had gone into premature labor with Ryan, I brought her to the hospital, where doctors began attempts to delay delivery. I was beside myself. On my way home to pick up some things for the hospital stay, I stopped by the place where my dad worked.
“What’s wrong, Boy?” he said.
I could barely get the words out, and he gave me a hug. Then Dad headed for the hospital to join the long vigil. Many months into Ryan’s hospital stay, when we were able to hold and rock him, my dad relished his turns to cradle his tiny grandson. And no one was more joyful when we could finally bring Ryan home. Dad stayed with him one night so Nancy and I could get out for a few hours. When we returned, the size of Dad’s grin betrayed his pride.
“We had a good chat,” he said. “I gave him his bottle.”
Dad also had a poet’s heart. He did not often reveal it, but there was no concealing it after Ryan died. It was my father who gave me the blank journal to write my story. He wasn’t a particularly psychologically sophisticated fellow, but he knew what I needed. He tucked the following note inside the journal:
Think of Ryan as one of these large foundations that give gifts to worthy causes. Except that Ryan can give a gift of love. He received so much love from so many people in his short life that he can return it for you or anyone else who thinks of him. If you ever feel depressed, think of him (I know you will think of him always), and he will share that love with you so that you can go on to face life, and that life is better for having him with you if only for such a short time.
Nearly two years later, on Saturday, May 14, 1983, Dad came by our home in his old Mustang. He said he wanted me to help him try to figure out a minor mechanical problem. I think it was really his excuse to get to see Kevan, his new grandson, who had been born three months earlier. The next afternoon, I got a call that my dad had not shown up for work.
He had recently been treated for heart problems, but I tried not to think the worst as I raced to the apartment where he lived alone. He was sitting in a chair, his body visible through the window, but the door was locked. He wouldn’t answer. I tried to convince myself that he was just in a particularly deep sleep. The apartment manager let me in. Dad had one leg comfortably crossed across the other, a book open at his side.
Once again, shock washed over me. Once again, my heart was broken. Bill O’Malley was only sixty-four years old.
We held a graveside service two days later, on the second anniversary of Ryan’s death. In my eulogy, I expressed my thoughts:
In thinking about him, I’m aware of the many contrasts that made him who he was. He was a man who experienced a great deal of loss in his life, but also joy. He had a profound sense of sadness about him that was cared for by a marvelous sense of humor. He often stated his preference for being alone, yet would talk for hours with those who would listen. He would be tearful and speechless when those he cared about were in pain.
It seemed that in the last few years he did find what he wanted: a very simple, unencumbered lifestyle with a few close friends and a lot of time — time to spend with his children and their spouses and his grandsons and time to be alone, to read, and fish and think.
Our son’s grave was just outside the burial tent at the cemetery. After the service, we paused there on the way to the car. It just seemed unreal to be there again, first and third generations buried twenty yards apart, sorrow on top of sorrow.
Just that quickly I had crashed from the mountaintop of new fatherhood to the familiar dark place where I had lived for so much of the time since Ryan’s death. Caring for little Kevan took some sting out of the sadness that distracted me, but for another long summer, I lived in a large pool of sorrow. I felt tugged in two directions, between birth and death; joy and sadness were separated only by a heartbeat.
After my father’s death, I took two weeks off from work, having learned from Ryan’s death that taking more time was better. I tended to Dad’s estate and rested. I held Nancy and Kevan close. And then it was time to return to the world.