After a long public battle, private grieving can begin

April 01, 2005|By Kate Shatzkin and Linell Smith | Kate Shatzkin and Linell Smith,SUN STAFF

For Terri Schiavo's family, the high-profile legal battles are over. Now their extraordinary case turns to the ordinary, private work of grieving.

But that work may be made harder by the fact that, along with a loved one, a cause of many years has died, experts say.

"Yesterday their lives were focused one way, pretty much full-time devoted to this cause," says Katherine Shear, a professor of psychiatry and director of the Bereavement and Grief Program at the University of Pittsburgh School of Medicine. "Next thing you know, it's not there any more."

When Schiavo died yesterday -- 13 days after a feeding tube was removed from the severely brain damaged woman -- Joan Finn's grief rose to the surface, although it is never far from there. It's been six years since her son died in a Virginia nursing home after she similarly lost a legal and intra-family battle to keep him on a feeding tube.

"I grieve for them," she says of Terri Schiavo's family. "I was very sorry to lose my son. It never ends as far as losing a child.

"I've certainly felt grief the whole time," she says, "and even now."

Hugh Finn had been in a persistent vegetative state for three years after a car accident when his wife requested that his feeding tube be removed. That launched a legal battle with her in-laws that, like Schiavo's parents, the Finns ultimately lost.

In cases when a parent has fought -- legally or otherwise -- to keep a child alive, the death can feel like a personal failure, says Debbie Jones, a bereavement counselor with the Hospice of Baltimore for 10 years.

"There's a feeling they let the person down," Jones said. "They didn't fix it."

`Complicated grief'

Parents who lose adult children sometimes suffer from what Shear calls "complicated grief" -- a persistent state of mourning from which they are unable to move on. "It's a situation where grief doesn't take a very natural course. It sort of gets stuck," she says.

The Rev. Christine Kennedy, who manages grief counseling for Hospice of the Chesapeake in Arnold, says grief is highly individual, and its duration hard to predict. But the publicity that has accompanied such a normally private event is bound to make it harder for those intimately involved to adjust, she says. "The media attention, the polemic issues -- these things are only going to extend that time frame."

For Michael Schiavo, who for years has tried to allow his wife to die, much of the grieving has likely taken place, experts say.

George Bonanno, an associate professor of psychology at Columbia University's Teachers College, has conducted research that shows family members with loved ones dying of AIDS often hit a low point before the person had died.

"They had kind of said goodbye," he says. "It's probably what [Michael Schiavo] did long ago."

Doreen Horan, manager of the Center for Grief and Loss at Stella Maris, a hospice and long-term care facility in Timonium, says it is clear that Terri Schiavo's husband and her parents were at two different stages of grieving. That, she says, would have only added to the tension and anger between them.

"In my humble opinion, back in 1998 her husband was ready to make peace and relinquish the woman he had married," she says. "Her parents have not yet accepted the place she is.

"He was ready to move on and make a new purpose for his life. They were still feeling anger, guilt and helplessness. They were still protesting her condition." Deanna Mack lost her quest to have her husband Ronald W. Mack's feeding tube removed years after an accident left him with irreparable brain damage. Mack's father eventually gained custody of him. Ronald Mack, of Essex, died in 2003 -- 20 years after the accident.

His wife had moved to Florida years before with the couple's two children, who are now grown.

Like Michael Schiavo, Deanna Mack started another relationship. She had a third child. But she says she felt she was in emotional limbo until she learned of her husband's death. She says she sought to end her husband's life support because he detested hospitals and would not have wanted to live as he was.

"If he had died a sudden death, you're shocked, you're hurt, you grieve," Mack says. "But I had a 20-years' living death. I was living with death for 20 years, waiting for his last breath. It was that unknown. Every night I prayed for 20 years: `Please God, take him.' ... I still do it because my brain doesn't realize he's dead."

But for Schiavo's parents, Bob and Mary Schindler, the grieving process may be very different.

Not letting go

"I'm not even sure I believe in anticipatory grief as far as parents are concerned," says Ann Finkbeiner of Baltimore, who wrote After the Death of a Child: Living With Loss Through the Years after her son's death at the age of 18.

"When they're talking about dealing with a long illness, I've never heard parents say `I had a few years to get ready for this,' says Finkbeiner, who interviewed bereaved parents for her book. "I've heard them say, `You just don't give up until it's all over and then you don't give up in a different way -- which is to say you don't let go.'"

Sun staff writer Susan Reimer contributed to this article.

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