Shirah Vollmer MD

The Musings of Dr. Vollmer

Archive for the ‘Death and Dying’ Category

Mourning Time

Posted by Dr. Vollmer on July 8, 2013

Bethany, fifty-six, just came back from a memorial service for Zach, a sixty-one year old male friend/acquaintance that she has not had contact with for over five years. Bethany’s ambivalent relationship with Zach tortured her at the service. ” I know I am not supposed to speak ill of the dead, and I know that Zach and I had some really good times over the twenty years that I knew him, but when I think about him, I think that he made me feel bad, so much of the time, that it is hard for me to grieve for him and his family.” Bethany describes her struggle to mourn, to “show up” to a place where her feelings are mixed, and her honest comments would have been negative and inappropriate. Bethany maintained the double life of sympathy and antipathy. “Clearly you went because you felt your presence was important-for you and maybe for Zach’s loved ones,” I say, highlighting the mixture of emotions that Bethany was feeling. “Oh yes. I really liked his wife, and of course, that is who is left, so it made sense for me to show up, but I had to bite my tongue and that was hard.” Bethany says, describing how her internal dialogue weighed on her, as people spoke about Zach and all of the wonderful things he had done for others. “Grieving is hard, but it is even harder if your feelings are so mixed,” I say, repeating an old theory, that the more ambivalent the relationship, the harder the grief. “Yes, in my fantasy life, I wish I could have stood up and told the story of how he hurt my feelings, so very deeply.” Bethany says, inviting me to ask her about that story. “When I had a large loss in my life, Zach, seemingly uncomfortable, kept telling me how I should feel bad for a mutual friend of ours, who was struggling with his elderly  mother. I thought Zach was painfully insensitive at that moment, and it really hurt.” Bethany says with tears, as she calls up this memory. “It is interesting that that insensitive moment stood out so strongly for you.” I say, wondering why Zach’s response was so penetrating for her. ” I just wanted him to ask how he could be there for me, and not tell me how I should be there for our mutual friend,” Bethany says, knowing now that she can never have that discussion with him. “This is a hard session,” I say. “We have never spoken about Zach before, but I get the sense he was a very important person in your life,”. “I guess I just found that out,” Bethany says, with a touch of humor in this heavy visit.

Posted in Death and Dying, Psychotherapy | 3 Comments »

Daniel Pearl: Ten Years Later-The Grief Never Ends

Posted by Dr. Vollmer on January 31, 2012

David Remnick, the editor of the New Yorker spoke at the Daniel Pearl Memorial lecture,, marking ten painful years since the unbearable torture and subsequent death of Daniel Pearl. What moved me was not Mr. Remnick, although he was an excellent and charismatic speaker, was the Israeli Dr. Judea Pearl, the  grieving father of Daniel Pearl. I have no relationship with the Pearl family, and yet, as Professor Pearl spoke about his son “Danny” I felt very connected to him. Here was an extremely intelligent man, Judea Pearl, speaking about his disbelief that anyone would want to hurt his precious son. Clearly he knew how dangerous Danny’s job was. Clearly he knew that after 9/11, our world had changed. As an Israeli, he must have also understood terrorism-the randomness of horror. Yet, he said so sweetly, that he just could not imagine that Danny would not return home. I was so moved by what I perceived to be his grief; his agony over trying to understand how this could happen.

     Before the lecture there was a montage, like a celebration, where pictures from Danny’s life were flashed on the screen. There was Danny, the little boy and there was Danny the classical musician. There was Danny’s wedding and there was Danny a little boy again. After that moving introduction to this lecture, it was hard to focus on the following three introductions which ultimately led up to David Remnick’s talk on free speech and the future of journalism. I managed to understand that from Mr. Remnick’s point of view, we live in a good news, bad news environment when it comes to the media. The good news is that the internet has created free speech like we have never had before. The bad news is that no one wants to pay for investigative journalism and so in-depth coverage is likely to be sparse. Yet, my mind kept returning to the Pearl family. There is no good news for them. Sure, his wife was pregnant at the time, and they are the proud grandparents. Sure, the world mourns Daniel’s loss with them, so maybe they don’t feel quite so alone. Still, to be in their presence, even amidst the  four hundred other audience members, is to feel the unbearable grief of a parent. Words fail to describe the feeling. At the same time, the series is about how Daniel Pearl believed in the power of words to make the world a better place. Both are true.

Posted in Death and Dying, Media Coverage, Parenting | 3 Comments »

The Accidental Patient

Posted by Dr. Vollmer on March 1, 2011

Jack, fifty-four, was telling me how hard it was to cope with his ailing ninety-three year old father. He agonized over how much stress his dad was putting on his fifty-six year old sister, Juliana. I wondered aloud, “maybe I could meet her; maybe that will help me understand you better. Also, maybe I can suggest some ways for her to get some relief.” Jack, hesitant and enthusiastic at the same time, said “well, I will ask her.” Six months later, Juliana and Jack come for a session. Jack sits there quietly as Juliana and I get to know each other. Juliana is there as an informant, not a patient. I need to tread gently, so as not to make her feel like she is the focus of attention, yet at the same time, my questions are directed at her about her concerns about her dad. Some moments are more sensitive than others. She tells me that certain things are private and she would rather not discuss them. I readily agree, but I am curious about whether the issues are private or shameful. Maybe that is the same thing. At the end, Juliana and Jack leave. I think the session went well, but I am not sure. Jack returns to his next appointment with great enthusiasm. “Juliana wants to go to therapy,” he says with great hope. Juliana has never been in psychotherapy, and in the past she had little respect for the process,  but she is now open to going. Although she has had struggles before her father became frail, she has refused any mental health intervention. Now, Jack feels the tides are turning. The one session with me, according to Jack, made Juliana realize that she could be understood; that her conflicts could be resolved, at least partly. Maybe she also felt unburdened. It seemed that way to me, although I am not sure she would agree.  “The accidental patient,” I say aloud to Jack, thinking that I was not sure that Juliana would be open to  psychotherapy. In the end, Juliana felt like a dry plant, with psychotherapy giving her the needed water in order for her to survive her fears. The experience of feeling heard can be powerful. I know that, but it is always a challenge.

Posted in Aging, Death and Dying, Psychotherapy | 2 Comments »

The Blues

Posted by Dr. Vollmer on February 11, 2011

Jesse has the “blues,” as she calls it. She is thinking about her mother; her mother who passed away two years ago from pancreatic cancer. “I just can’t believe she is not here,” Jesse says with wonder and overwhelming sadness. “You really miss her,” I say, thinking that some deaths create a lot more sadness than others. “Yea, my dad passed away a year ago, but I hardly think of him. My mom I think about everyday. I just want to call her and tell her what I am up to.” Jesse says as she starts to cry. “No one understood me like my mom did. Sure, she was not perfect. She was really judgmental and intense, but she was a really good listener and I miss that,” Jesse says as she continues to cry. “I know that you and I have a relationship and I know you feel that I listen, but of course, it is not the same as the daily contact you had with your mom.” I say, reminding her that she does have other people in her life who can listen to her, but at the same time, I want to acknowledge that her mom’s passing has created a hole in her psyche. “Missing is a really hard feeling, because you feel so helpless and because even though other people might try to be there for you, no one can replace your mom.” I say, reminding her that I can see why she is so sad and how I understand that; maybe I can help a bit, but the hole is still there and I appreciate that too. “Maybe sharing the feeling of missing can help” I say to Jesse, trying to connect with her even though her sadness is pulling her inwards. “I don’t know,” she says, “I just want this feeling to go away.” “Yea, me too,” I say, both because I feel that way and because I want to offer, what seems to me, to be a needed echo.

Posted in Death and Dying, Musings | 2 Comments »

“Dad, I Have A Stomachache”

Posted by Dr. Vollmer on January 14, 2011

    Milly, fourteen, just lost her mother, Penny,  to metastatic melanoma. Penny had been sick for five years, on and off. When Penny passed, it seemed sudden, despite her poor prognosis. There was a memorial service; three hundred people attended, told Milly how sorry they were. Milly went to school the next day. She continued participating on the dance team, hanging out with her friends, and doing well in school. Brad, Milly’s father asked me “what should I be worried about with Milly?” “Keep an eye out for signs of distress. It may happen soon, but it also may happen weeks or months from now,” I said, trying to explain that reactions to death have no precise time frame. Brad leaves with a feeling of uncertainty, trying to deal with his grief and Milly’s grief at the same time.

      Three months later, Brad calls me and says “Milly is having stomach-ache.” “You should take her to her pediatrician to rule out any gastrointestinal illness, but at the same time, I am wondering if she is now expressing her feelings about Penny’s passing.” I say, thinking that Milly’s stomach-ache may be her ticket to discuss her internal distress about losing her mom. Brad, somewhat robotic, says “OK, I will call her pediatrician and then I will take her into see you.” “I could see her before you take her to her pediatrician,” I respond, emphasizing the time urgency of the situation, since Milly seems ripe to talk about her feelings. Brad agrees, again in a robotic fashion. Brad sounds scared and overwhelmed by Milly’s stomach-ache. “It is just a lot for me to handle,” Brad says, implying that dealing with Penny’s death has been overwhelming. “Well, maybe if we can help Milly feel better, that will help you feel better too,” I say, trying to say how his whole family is hurting, so dealing with one part will help the other parts. I also think that Brad could benefit from psychotherapy, but I don’t feel it is the right time to bring this up. “Thanks for seeing her,” Brad says to me in a kind and grateful tone. “Your welcome,” I respond, thinking back to our earlier conversation when he asked me when Milly was going to express her grief. Brad seemed to feel reassured that my prediction that Milly will react to Penny’s passing at a time when Brad least expects it, came true. Some things are obvious to outsiders and mysterious to those living through it; Brad and Milly were such a case.

Posted in Child Psychotherapy, Death and Dying, Grief | 2 Comments »

Watching A Loved One Die

Posted by Dr. Vollmer on October 4, 2010

     Jorge, fifty-five, knows that his wife Roseanne is dying. She has terminal lung cancer; she never smoked. She is also fifty-five, has three grown children from a previous marriage. By Jorge’s report she has loved her life ever since she met him twenty years ago. The doctors, “I love them,” Jorge says, have told them to enjoy the rest of their days-meaning days, weeks or months-no one knows. Jorge does not come to see me because Roseanne is dying. Jorge comes because he suffers from panic attacks; for the last fifteen years Jorge checks in with me once a month to renew his medication. We have not changed the dose in over ten years; we have talked about it many times, but he is so happy with the way things are for him, he does not want to “mess things up”. Now, we talk about how Roseanne is doing; how Jorge and Roseanne are doing. Every month is worse than the month before; it is a slow death. The slowness is a blessing and a curse. Jorge is prepared; he is also tired of seeing Roseanne suffer. I serve as a touchstone; someone who cares, but who is not suffering in the same way as his friends and family do. I think Jorge is going to cope with Roseanne’s demise. I suspect he will be sad, but not guilty. Together, they seem to have created a loving transition from life to death. It is strange to think of feeling privileged in such tragic circumstances; yet, that is how I feel.

Posted in Death and Dying, Musings | 4 Comments »

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