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A grief deferred

BMJ 2000; 321 doi: (Published 02 December 2000) Cite this as: BMJ 2000;321:1420

Seventeen months separate the birthdays of my two eldest sons—the same gap as that between mine and my eldest brother's. Sadly, he died when I was 13, but it came as something of a surprise when I started to grieve for him 32 years later. However, as I reflect on the intensity of the interaction between my own children in their early years, perhaps I should not have been surprised that for me there would be a thorough grieving process, albeit deferred.

My brother's death was sudden and traumatic. Events of that day are abiding images. His body was found by my mother, followed by the rest of us. I remember the futile attempts at resuscitation, the ambulance men, the policemen. I remember my mother's affectionate embrace and words of comfort as we were reunited that evening when all the activity was over. I remember the coffin, the wreaths, standing at the graveside, sitting in a hearse. I remember my father returning from the inquest and discussing its findings with us.

Childhood scenes before that day are mainly stills rather than video scenes, my brother sometimes a shadowy figure in those snapshots from a happy childhood in a secure, loving home, marred only by that one momentous day. Until this year it was as if my brother was only in those brief memories. Perhaps observing the relationship between my sons in their childhood has led me to recognise the closeness of the relationship that existed between my brother and me and, therefore, has made me appreciate my loss.

Childhood scenes before that day are mainly stills rather than video scenes

Curiously, my diary entries of that period have little in the way of relevant detail. Those recorded seem very matter of fact: there were many visitors; I attended his funeral. After this we stayed with friends for about three weeks before returning home. I could not have entered into my parents' trauma of clearing my brother's bedroom at the end of this time, although I recall the day. I do not recall shedding tears at any time.

As I became a parent myself the impact of the loss to my parents became more real

I assumed the position and responsibilities of the eldest son, with two younger brothers. If I was asked how many siblings I had, I would reply, “Two.” It was as if our family had contracted to five.

Over the years we spoke little of him at home, and there were no photographs on display. Tacitly, it was agreed that the trauma would be too great. That is not to say that his memory was blotted out. On the contrary, I thought of him frequently, particularly at anniversaries of his birth and death, and a photograph of him has been displayed in my study for several years. However, I did not visit his grave again for some 13 years, but that visit was cathartic.

Perhaps not unexpectedly, as I became a parent myself the impact of the loss to my parents became more real to me. This recognition of their loss reached its zenith at a recent impulsive visit I made to his grave. The simple inscription “… beloved son of …” underlined the exclusivity of their relationship, particularly as he was their first born. However, it seemed to me that my being moved at the thought of their loss was at least partly a transference mechanism of my own sense of bereavement. After that visit, in spite of having a personal faith in a loving God and an unshakeable belief that his body was but a shell for his long departed soul, I was distraught that I had abandoned him all alone on that cold, bleak hillside, although comforted by the knowledge that we would one day be reunited.

It is only in recent months that I see in greater clarity the fact that there is a quarter segment missing from among the whole of my parents' children. This is particularly obvious when we have a family reunion, including all our offspring. What would he now look like? What would be his work? Would he have married? Would he have had children?

It concerned me that, for one who regarded himself as being well balanced, I might be going through an abnormal bereavement reaction 32 years later, but is it pathological? Was I not previously seeing the loss through the eyes of a child, but now through the eyes of a man, and of a father?

Where am I now in the textbook bereavement process? I guess that I am at the resolution, acceptance, reorganisation stage, which I understand lasts from 12 to 15 months. But when did it start, and when will it end?

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