<p>‘Tell me about despair, yours, and I will tell you mine. Meanwhile the world goes on…’ -Mary Oliver.</p>.<p>It is hard to believe that merely five years ago the world was reeling with a pandemic that brought death, loss and grief to every village in every country. And yet, we have moved on. The experience of grief is linked to the experience of love and attachment. It is the inevitable outcome of the loss of love. As we move to an individualistic society with urban migration and nuclear families, people suffering loss struggle to find compassionate communities to help them cope with their grief. The pandemic changed the way we bid goodbye to our departed loved ones too. Families and communities forced by circumstance to be strong and resilient still carry the trauma of incomplete farewells, and grieving that was not given the space it deserves. </p>.<p>However, we cannot truly move on from grief, we have to learn to move forward with grief. Ancient and rural societies had elaborate rituals around death which may have helped them cope with loss as a community. Many of these rituals were based on beliefs that are challenged by the day-to-day truths of our lives today. While some people find solace in religious rituals and prayer, others chafe under the expectations of customs that seem incongruous with their current lives. There is no established timeline for recovery from loss, but professional demands often do not allow for adequate time to begin the process of healing. And so, grief remains a wound which doesn’t receive attention it requires.</p>.<p>Neuroscientists and psychologists have made strides in understanding how grief changes our brains and its responses to everyday challenges. We now understand that unaddressed and complicated grief contributes to future physical and mental health issues. Elizabeth Kubler Ross, the Swiss American psychiatrist and pioneer of research in the lived experience of patients and families faced with terminal illness gave us some of the earliest frameworks to understand death and dying, grief and grieving. There is more to grief than the five stages of grief initially described – denial, anger, bargaining, depression and acceptance. The stages are not universal and do not always happen<br> sequentially. Beyond these stages lies the difficult road of walking through life without a loved one, learning, growing and rediscovering meaning and purpose, with acknowledgement of grief as an integral part of life.</p>.<p>Dame Cicely Saunders, the pioneer of the hospice movement in the late 1960s, said –‘The way we die lives on in the memory of those we leave behind.’ Decades later, medical science continues to improve health outcomes with newer drug discovery, procedures and technology. People live longer, but not everyone is assured of a better quality of life. More people die in hospitals than ever before, even when their death was anticipated due to a progressive terminal condition. Patients and families need the support of palliative care teams as they face the anticipatory grief of impending loss. The medicalisation of death and pathologisation of grief, amplify the suffering of what should be natural phenomena. Death in an intensive care unit connected to machines is not what anyone would consider a good death. Death distanced from loved ones complicates the recovery of the grieving families. Recent advances in India and Karnataka have made it possible for people to make their advance medical directives to guide their doctors to provide value-aligned medical care at the end of life. This is an important step to empower citizens, patients with progressive illness to have autonomy over their health decisions and choose dignity in death. </p>.<p>It is imperative that we build compassionate healthcare systems that understand that the role of medicine is as much to save the lives of those with treatable conditions as it is to support those whose death is inevitable. In 2025, as a society that has come through the fire of a once-in-a-lifetime health global health crisis, is it too much to ask that every hospital has a palliative care department and every modern ICU has a grief counsellor, psychologist or social worker to support suffering patients and caregivers? The priorities of a healthcare system are guided by the preferences of the communities they serve. It is time for us to prioritise an acceptance of grief as an integral part of healing in society.</p>.<p>The ‘Good to go: Death literacy festival’, scheduled for this weekend in Bengaluru, will focus on grief and its many aspects, opening space for much-needed conversations.</p>.<p><em>(The writer is an interventional pulmonologist and palliative medicine practitioner at a Bengaluru hospital)</em></p>
<p>‘Tell me about despair, yours, and I will tell you mine. Meanwhile the world goes on…’ -Mary Oliver.</p>.<p>It is hard to believe that merely five years ago the world was reeling with a pandemic that brought death, loss and grief to every village in every country. And yet, we have moved on. The experience of grief is linked to the experience of love and attachment. It is the inevitable outcome of the loss of love. As we move to an individualistic society with urban migration and nuclear families, people suffering loss struggle to find compassionate communities to help them cope with their grief. The pandemic changed the way we bid goodbye to our departed loved ones too. Families and communities forced by circumstance to be strong and resilient still carry the trauma of incomplete farewells, and grieving that was not given the space it deserves. </p>.<p>However, we cannot truly move on from grief, we have to learn to move forward with grief. Ancient and rural societies had elaborate rituals around death which may have helped them cope with loss as a community. Many of these rituals were based on beliefs that are challenged by the day-to-day truths of our lives today. While some people find solace in religious rituals and prayer, others chafe under the expectations of customs that seem incongruous with their current lives. There is no established timeline for recovery from loss, but professional demands often do not allow for adequate time to begin the process of healing. And so, grief remains a wound which doesn’t receive attention it requires.</p>.<p>Neuroscientists and psychologists have made strides in understanding how grief changes our brains and its responses to everyday challenges. We now understand that unaddressed and complicated grief contributes to future physical and mental health issues. Elizabeth Kubler Ross, the Swiss American psychiatrist and pioneer of research in the lived experience of patients and families faced with terminal illness gave us some of the earliest frameworks to understand death and dying, grief and grieving. There is more to grief than the five stages of grief initially described – denial, anger, bargaining, depression and acceptance. The stages are not universal and do not always happen<br> sequentially. Beyond these stages lies the difficult road of walking through life without a loved one, learning, growing and rediscovering meaning and purpose, with acknowledgement of grief as an integral part of life.</p>.<p>Dame Cicely Saunders, the pioneer of the hospice movement in the late 1960s, said –‘The way we die lives on in the memory of those we leave behind.’ Decades later, medical science continues to improve health outcomes with newer drug discovery, procedures and technology. People live longer, but not everyone is assured of a better quality of life. More people die in hospitals than ever before, even when their death was anticipated due to a progressive terminal condition. Patients and families need the support of palliative care teams as they face the anticipatory grief of impending loss. The medicalisation of death and pathologisation of grief, amplify the suffering of what should be natural phenomena. Death in an intensive care unit connected to machines is not what anyone would consider a good death. Death distanced from loved ones complicates the recovery of the grieving families. Recent advances in India and Karnataka have made it possible for people to make their advance medical directives to guide their doctors to provide value-aligned medical care at the end of life. This is an important step to empower citizens, patients with progressive illness to have autonomy over their health decisions and choose dignity in death. </p>.<p>It is imperative that we build compassionate healthcare systems that understand that the role of medicine is as much to save the lives of those with treatable conditions as it is to support those whose death is inevitable. In 2025, as a society that has come through the fire of a once-in-a-lifetime health global health crisis, is it too much to ask that every hospital has a palliative care department and every modern ICU has a grief counsellor, psychologist or social worker to support suffering patients and caregivers? The priorities of a healthcare system are guided by the preferences of the communities they serve. It is time for us to prioritise an acceptance of grief as an integral part of healing in society.</p>.<p>The ‘Good to go: Death literacy festival’, scheduled for this weekend in Bengaluru, will focus on grief and its many aspects, opening space for much-needed conversations.</p>.<p><em>(The writer is an interventional pulmonologist and palliative medicine practitioner at a Bengaluru hospital)</em></p>