MAY 24, 2007 – THE DEATH OF A MOTHER: INTEGRATING PERSONAL AND PROFESSIONAL KNOWLEDGE: DAVID BROWNING.

 When David Browning was thirteen years old, his mother Harriet died after an extended struggle with lung cancer. Like many children who lose parents, the trajectory of his life was then shaped by the impact of that loss. A practicing therapist and educator for twenty-five years, David has sought to understand what it means to be a professional caregiver when one’s own identity has been fashioned by loss. He has published several essays and articles articulating the need for healthcare professionals to better understand the rich intersection between personal experience and professional knowledge. Currently, David is Director of the Initiative for Pediatric Palliative Care (at Education Development Center, Inc.), a national project aimed at transforming the culture of healthcare for children with life-threatening conditions and their families.

David Browning:  I was close to my mom, and as is true in a lot of families, children get particularly often closer to mothers especially in that generation than with fathers so the loss was kind of like other grieving people talk about these kinds of losses.  You’re really not quite sure who you are after a death like that and you’re not quite sure about your own survival after a death like that.

David Browning:  I think that we have concepts of saying goodbye in our culture around grief that are very shaped by our culture and that most grieving people do not say goodbye in any kind of final way to their loved ones.  They remain connected to them.  Very many grieving people remain connected to their loved ones after they die and our culture doesn’t always understand the healthy ways that people do that. 

David Browning:  There was a point right before she died.  It was really just hours before she died when she turned away meaning she needed to get ready to die, and I think that happens in families at a certain point with dying folks that they get to a point sometimes where they’re sort of summoning energy for their next passage.

David Browning:  It has to be okay to cry.  Now that doesn’t mean that it’s particularly helpful if a helping person is overwhelmed by sadness and can’t be in a helping role, but I think what we’re learning from the research that we’ve done in our project and that has been done in other parts of the healthcare world is that families for the most part are telling us that when healthcare professionals are engaged and show their authentic feelings around let’s say the death of a child, that that’s something that is deeply and helpful and meaningful for the most part, not always, but for the most part for families.

David Browning:  For folks that really want to be in a position of giving something back or helping to change the system from the family member perspective, I think contacting your local hospital and asking about any programs that utilize family members is probably the best place to start. 

David Browning:  To answer your question “what’s the biggest mistake professionals make?” I would say the biggest mistake comes from something we’re actually taught to do which is to distance ourselves in ways that I’m not sure are particularly helpful to families but furthermore I’m not sure they’re particularly helpful to us ourselves that we distance ourselves when we’re helping families as if kids and families live in a different universe than we do and it’s not true and therefore from a learning and knowledge perspective, it’s not a good way to learn things. 

David Browning:  Well, that’s something I wrote seven or eight years ago and one of the things that those of us that have had losses when we are children know very well if they are losses that are worth their salt if they are big losses, they last a lifetime.  It’s not to say that life doesn’t go on or that we don’t find a happiness in our lives and build a good life after a major major loss, but I wrote that seven years ago at the age of I don’t know, 48, and that’s when some of these things were coming together for me.  I think actually that fits with what we now understand about the grief of children and as they grow up to become young adults and adults which is that children grieve developmentally so that if – for a child that loses a parent, what they need help with as they grow through their lives is ways of encountering and re-encountering that loss and making meaning of that loss in a framework that fully understands that this will keep going on indefinitely, which again is not to say that one’s life is in a mess indefinitely.  It’s just to say that the meaning-making process keeps going on.

David Browning:  What children need around them even if the rest of the family system has transformed to something else which is another part of this because sometimes spouses get ready to take on a new spouse, for example, whereas a child never takes on a new parent.  You might take on a stepparent, but you don’t replace a parent that’s died, and so for kids, they need a loving environment around them so that when they reach graduation, there are folks around them that fully understand why they’re missing dad at graduation.  Why they are longing to be like other kids at that time.  And as long as that framework is around them, they I think have a much better potential to kind of work in a healthy way on the loss throughout their lives.

David Browning:  I totally agree with that, Heidi, that that’s the side of the environment around kids.  That kids are not always going to make those connections and to have parents that, and family members and close people that are close to that kid being able to say, I wish daddy could be here, which is actually a beautiful way of saying it because it’s not – could be here to see you – it’s a beautiful way of saying it because it’s not even telling that child that you’re sad because this is a time you wish your father were here.  It’s not an interpretation.  It’s saying I wish daddy were here to see this and it gives permission for that child, if that’s what the connection is, for them to feel free exploring that.

David Browning:  There’s another part of this that’s important with siblings which is that in addition to recognizing that they’ve been invisible for so long that there’s a challenge of recognizing the ways in which they are in pain.  There’s also an equal challenge to recognize the strengths that they’ve developed by virtue of being siblings of kids that are dying. 

David Browning:  Don’t accept anybody else’s ground rules or don’t accept anybody else’s rules about what it is that’s supposed to be happening.  Grief unfolds in such unique ways in families and also in individuals that families need – people need to feel comfortable going through the process that they need to go through and I know in support groups like The Compassionate Friends when it’s about the loss of a child, that that’s really kind of a basic, a premise that yes, there may be certain things that we all know like holidays tend to be hard times, etc., etc., but the more fundamental message, I believe, is that we’re here to create a loving environment around you for going through what you need to go through and we understand that this year it might be, you might feel like things are going, feeling pretty good and it might be five or six or ten or fifteen years from now that the loss hits you in a different kind of way and you come back and talk to us some more then.  And I think to the extent that people can surround themselves with that kind of thinking, it just allows things to unfold in ways that they need to and then, of course, part of it is having enough loving resources around whether in the form of community or family or professional helpers to kind of support people along the way.

David Browning:  The death of a child, whether it’s a sudden death or just any kind of death of a child because it’s so hard to take in that we think of that kind of suffering that families go through as something that’s just, has to be the most horrific thing in the world but unfortunately, as all of us who have experienced loss know, life involves suffering and some of the greatest directions that people take in life have to do with weathering a period of suffering and really what we’re talking about is making sure people have enough support to weather the suffering in positive ways so that they’re not done in by it.