Abstract
“The Group” is an ambitious book giving voice to the under-told story of being a widowed father, and what the evolution of grief looks like when you have not only lost the love of your life but would children have also lost their other parent. The book follows a group of seven widowed fathers as they come together once a month for a support group started by the authors Donald Rosenstein and Justin Yopp, both professors in Psychiatry at the University of North Carolina. Over the course of 163 pages, the book acts as both a window into a world of unimaginable loss and a map for the varied terrain of grief showing the rawest edges, lowest valleys, and new perspectives from uncharted vantage points.
The book is broken into three sections: the first section introduces the reader to the enormity of loss these men are facing. The power of the individual narrative is experienced as we are introduced to each of these seven men and their wives, and learn the details of how they met and how they faced suffering and death together. As a palliative care provider, it is easy to identify with the husbands and wives as patients and families we have cared for and been touched by: there is a wife who holds so steadfastly to hope that she and her husband are never able to together plan for what comes, and there is a mother who sees a future for her family where she is only there in the letters she writes and in the memories they will share. Through these seven experiences, we see the spectrum of ways in which patients and families cope with illness.
However, the real focus of the book is on the aftermath of these seven deaths, and it is here that we begin to gain a poignant perspective on life after loss and the stories of families we have only passed through as palliative care providers. We hear the grippingly personal story of one man faced with the completely surreal experience of taking his kids out for donuts the morning their mother passed away, because they are children and they are hungry and they need to be fed. We also hear about what it is like when the community supply of casseroles and offers to help with childcare dissipate and “it seems like everyone has gone on with their normal lives. And now it's all on me.” Despite the work we do with patients and families, most of us will never fully know this kind of loss and what life looks like afterward, but the raw details each of these men share about the days and weeks after the death of each of their wives powerfully portray the human condition, giving us more of a glimpse into this reality.
Within this first section, the authors also weave in their own expertise about grief. The first introduction of theories about grief comes somewhat abruptly with commentary on the well-known “5 stages of grief” from Elizabeth Kubler-Ross. Initially, it feels jarring to shift from emotionally gripping individual stories to a clinical dissection of what these men are going through: depression or grief, normal waxing and waning, or pathologic complicated grief. However, there is value in imparting this structured way of thinking at this point in the book. The magnitude of loss is heavy and chaotic and both for the men and the reader, it feels easy to get lost in the immediate weight of it all. In deconstructing the popular stages of grief and introducing the idea of The Dual Process Model wherein there is always grief but people oscillate between “loss-oriented stressors” and “future-oriented stressors,” Klopp and Rosenstein give a sense of structure for thinking about grief and how it may manifest, both in the immediate time of loss and in the years to come.
The later two sections of the book help to more fully develop our understanding of the ways in which grief continues to evolve months and years out from loss. These sections thoughtfully address very real issues these widowed fathers are faced with, from helping their kids cope with their own grief to considering what it means for each of them to remove their wedding rings. This longitudinal look at grief provides an even broader perspective for palliative care providers about grief over time. It also becomes strikingly clear that these stories also serve to draw a map for men faced with similar experiences: not there to provide answers, but to give a lay of some of the land from others who have traveled across it.
“The Group” successfully sheds light on grief both immediately surrounding loss and in the years to come. It effectively informs a part of the human experience we are not often witness to as palliative care providers. On a personal note, I sat down with “The Group” three weeks before marrying the love of my own life. It is worth recognizing that normal people probably do not enter into marriage thinking at all about what their husband will do when they die, but there is something to be said for how this work makes us all a little abnormal. Regardless of the strange timing, or perhaps because of it, I could not help but think: while I hope he never does, should my husband ever need it, I would be glad “The Group” is there for him to wonder less about what is “normal” in the setting of grief and to be able to find support through this community's heartbreaking shared experience.