BOOK REVIEWS

Enduring Grief: True Stories of Personal Loss

FROM OMEGA...

 

"Enduring Grief: True Stories of Personal Loss provides a refreshing and long overdue insight into the experience of loss. The book’s uniqueness is in its case study method of presentation. Placed in the context of a literature about death and dying built primarily upon theoretical accounts of grief and descriptions of research conducted on bereavement, this book is an unsual collection of personal stories. The brief length of the stories (generally 3-4 pages each) and the real voices from which they are told make them both accessible and meaningful to a wide audience of readers. However, while providing an inside view of the human experience of loss, this book sometimes make compromises in its quality of articulation and presentation. There are inconsistencies in the depth of insight and capacity for expression of the individuals to tell their story. Furthermore, although the books loose structure allows for an eclectic mix of experience to emerge, it's organization is confusing. It seems to try to speak to too many people at once.

"The book is divided into four sections: Loss from Death, Overwhelmed by Loss, Empowered by Loss, and Other Kinds of Loss. As Dr. Selder explains in the Preface, the individual accounts, which sum 68 in total, have been grouped by their most salient attributes. The scope of the book extends beyond loss by death to a much fuller and more appropriate representation of the types of events that evoke the grief response. The reader would be hard-pressed to find a type of experience connected with loss that has not been explored in this book. The degree to which these editors are comprehensive and compiling their collection of stories it's a real tribute to the depth of their understanding of grief.

"While the first section of the book is structured around the event of loss from death, the second and third sections are organized around the reaction to loss. The final section is a collection of anecdotes of grief in response to losses other than death. These headings seem somewhat arbitrary, as many of the stories could appropriately appear in more than one place; they seem to create more confusion than organization. Within each section are a number of stories about the experience of loss; some stories are told by caregivers, usually nurses, and others are told by the people closest to the lost person or relationship. Some of the accounts are followed by "discussions” by the narrators of the story, and others are not.

"A wide range of topics are explored in this substantial collection of case material. The stories in the first section about loss from death address the challenges faced by caregivers, parents, siblings, relatives, friends, and survivors of miscarriage and suicide. The experience of a child who is dying and crisis management in the wake of death are also depicted in this first section. The books second section, which is unified around losses that have left the survivors in ongoing states of anguish, includes stories of the parents of a missing schizophrenic son, a doctor who lost a patient, a child abuser survivor, a lonely prisoner, a policeman, and infertile woman, a man with genital herpes, a lawyer who loses his case, a mother who accidentally kills her daughter, family members of Alzheimer’s patients, and the parents and brother of the boy who becomes paralyzed. The book's third section, Empowered by Loss, focuses on inspirational experiences of survivors of loss who were determined to move forward and grow through their grief. In this section, individual survivors and helping professionals tell their stories of donating life, transforming anger, coping with a disabling illness, enabling a family member to die with dignity, acquiring wisdom from dying patients, gaining a sense of control over one's death, and coping with adversity. The books final section describes a variety of experiences that are not necessarily traditionally acknowledged as losses, such as incest, divorce, job loss, cancer, dementia, eating disorders, disabilities, loss of sight, and loss of trust.

"The approach of collecting the experiences of a broad range of individuals who have sustained loss is quite innovative and for the most part highly effective. In some cases, however, especially rich anecdotes are offset by others that are that are not the thoughtful or well written. The variability in impact of stories seem to be a function of the capacities of the various writers, as well as the relationship of the storytellers to the loss. The accounts of individuals who have lost someone with whom they had a close personal relationship are substantially more illustrative then accounts by the caregivers of dying individual. Although less evocative, the notion of devoting so much attention to the helping professionals whose lives and identities are so closely intertwined with those for whom they provide care is both unique and highly valuable for training purposes. The reactions and experiences of these caregivers have long been neglected in the literature on death and dying. In particular, that this book addresses the emotional experience of nurses — often the primary caregivers of patients — needs to be underscored.

"The book's format has strengths as well as limitations. The preface, written by Dr. Florence Selder, appropriately sets the stage for the layout and purpose of the book. It is unfortunate that readers do not hear more of the editors’ perspectives on and thoughts about the contents of their collection. Perhaps discussions at the close of each section, or minimally at the conclusion of the book, would have enhanced the power of the content. Such analysis would've provided readers with a helpful integration of the ideas generated and themes inherent in the disparate parts of the book. There is a clearly annotated table of contents that provides a useful reference and is especially appropriate for readers who wish to read only those stories most relevant to their own experiences.

"In some respects, the diversity of relationship that the book's contributors share to the person whom they have lost blurs the clarity of the books intention and leaves the reader wondering who in fact it's target audience is. Is it individuals have who have lost? Is it caregivers to have lost? Or is it meant to be read by both? According to the editors, the book is intended to provide self help for anyone who has sustained a loss. Clearly any relatives, friend, or caregiver who has lost someone will find that Enduring Grief provides a useful and supportive means for connecting with the experiences of others who have suffered a similar loss. However, the book could've achieved its purpose more efficiently and clearly had it been written for caregivers or close relations or friends, but not for both. There is a qualitative difference between these types of losses.

"Although Enduring Grief does try to do too much at once, overall, it is a tremendously powerful account of a much-neglected aspect of grief — the personal, first-hand experience of those who have endured it. The editors’ approach is both innovative and unique. Their book was designed to make a meaningful contribution to the literature on deaf and dying and it succeeded."

Omega (Jane E. Coles, PsyD, The Brookline Center, Brookline, Mass)

FROM NURSING ONCOLOGY FORUM...

"Throughout the ages, storytellers have related life experiences from one group to another. The authors of this book use the art of storytelling to impart perceptions and lessons learned from those who have experienced grief through personal loss or in caring for others. Nurses, therapists, social workers, psychologists, physicians, and lay people explore their feelings and share their insights based on these experiences.

"Storytelling is therapeutic to the storyteller as well as for the listener or reader. In many of the experiences, the reader shares the writer’s feelings, emotions and grief. The storyteller often is “working out” personal feelings of loss. The book is organized according to the type of loss experienced, with many of the stories followed by a brief discussion and analysis on the manner in which the grief process was handled.

"As heart wrenching as the experiences of parental grief were, the insights of those who cared for these people were extremely valuable. Several of the stories related experiences of parents in the emergency room. The nurses and physicians found it most therapeutic to allow loved ones private time with their deceased child, regardless of the condition of the body or face. Reading about how parents unconditionally accepted their child without being repulsed by outward appearances or mutilation was amazing. Healthcare professionals in the emergency room presented their personal experiences in these situations, sharing their understanding of the importance of allowing family members to confront and mourn their loss rather than seeking to protect them from the hurt. Faced with these difficult and emotional circumstances, nurses and other healthcare professionals can learn from the experiences of their colleagues and develop therapeutic approaches to facilitate the grief process in patients and families.

"This book would be beneficial to any nurse or healthcare professional who deals with individuals and families coping with a loss. By sharing in the experiences of others, readers explore their own perceptions and feelings about death and loss. This book lends itself very well to facilitating discussion and could be incorporated into inservice education programs, nursing rounds, or classes for students in healthcare professions. Some stories include ethical dilemmas that make the reader examine his or her own personal beliefs and value systems in confronting these difficult situations.

"The reader is drawn into each story and is enriched by emotions experienced, whether sadness, frustration, relief, or despair. As nurses, we care for so many types of patients that we may not understand reactions to illness or loss and the far-reaching effects on our lives. In sharing the experiences of others, we learn empathy and become more therapeutic in providing support and understanding. The brief discussion at the end of many of the stories summarizes the manner in which the loss was handed and the individual’s perceptions of its effectiveness.

"In our increasingly technical healthcare environment, this book helps us revisit the essence of caring in the helping professions. Through shared experiences, we gain strength and a sense of connectedness to other human beings. This art of storytelling has been underused in the nursing profession. Every nurse should be familiar with this powerful therapeutic approach. This is an excellent book for experiencing and learning to appreciate the power of a story."

 

Oncology Nursing Forum (Jane Kaczorowski, RN, MS, OCN, CRNH, Bereavement Nurse Coordinator, University Hospice of SIUH, Staten Island, NY)