As another anniversary of Uzma’s death rolls around, I expect to get texts and messages from people who loved her saying some variant of, “Thinking about you on this difficult day.”
That they care to remember shows me how much they still love her and miss her.
There are many in that group whom I have never met or spoken to. And I hear from most of them only at this time of the year. That they still reach out to me shows how much they care about what — and who — mattered to Uzma.
If that’s not love, I don’t know what is. And I genuinely look forward to those messages.
I have to admit, though, that Uzma’s anniversary is no longer particularly hard for us. It’s not because we love her less than the friends and family who mark this day. It’s because her absence is not something that shows up only once a year.
Early on, her loss felt like an earthquake. Some aftershocks hit us out of the blue. Others, we had time to brace for — like her anniversary, the first few years. Still, every one of them would rattle us to our cores.
Over time, Uzma’s absence stopped shaking us. Because it went from recurring tremors to being more like gravity.
Gravity is a constant. Unremarkable. Essential. We don’t wake up thinking about it, but every step we take is shaped by it.
Uzma’s absence isn’t something we visit on her anniversary. It’s a unique thread woven into the fabric of our lives. That fabric wouldn’t exist without her thread.
We don’t think about her on any particular day. And we don’t not think about her on any particular day either. It’s a strange experience — one that still leaves me at a loss for words.
And like gravity, her absence shows up in ordinary ways.
In the way we think and feel. In the way we show up for friends. In the kids’ mannerisms and interests. In how I make decisions.
In these seven years, we have made many memories without her.
Millions of mundane ones — changing interests, evolving friendships, small daily routines that quietly build new parts of a life — like an addition to a house. Think also of school events and social events. Pick-ups and drop-offs. Classes considered and chosen. New restaurants dined at, new movies seen, new music heard.
She is also missing from many striking memories. A global pandemic survived. Road trips and vacations enjoyed. Milestones crossed.
Conversations about Uzma come up unexpectedly as we make new memories. But when we remember those new memories themselves, she isn’t in the scenes. Instead, our memory of her is. She isn’t present as a character. But always present as context.
When people text or message to say they’re thinking of us today, I welcome it. I don’t experience it as reopening a wound. I experience it as a reminder of how wide Uzma’s circle still is. And how her life continues to ripple through the lives of all who loved her.
That kind of love is always worth acknowledging. And being grateful for.
The kids and I were at our local swimming pool on a hot summer day a few months ago. The scent of chlorine and sunscreen swirled in the air. My daughter Gauri found some friends and was enjoying splashing around with them. My son Shuja and I sat in the shade of a tree. We started chatting about all sorts of things. Friends, hopes, dreams, summer activities, travel plans…life. At one point, the talk turns to Uzma, his mother, my late wife, and the creator of this blog. I ask him, “When you go over to your friends’ homes and see both their parents, do you ever find yourself wishing that mom was here?”
Uzma had died of metastatic breast cancer over four years ago at that time. While I tried my best to be a good solo parent, I know it’s not the same as growing up in a two-parent home. And two-parent families are the norm among my kids’ closest friends. While my kids are not the jealous type, I have often wondered if they see the glaring difference between their friends’ families and ours and feel something missing.
He didn’t respond immediately, sitting with the question for half a minute. It felt like several minutes. The laughter and splashing of kids in the pool started sounding louder. It all quieted down again as he said, “I don’t want you to take this the wrong way. I miss Mom, but I don’t know how to answer that question.”
“I am listening.”
“So much of our life has happened without mom. It is impossible to imagine what it would be like if she were still alive. Who would I be if she had been with us these last few years? Wouldn’t it depend on whether she was sick the whole time or well?”
That would make a big difference, I thought. I recalled how our life shrank as cancer grew in Uzma’s body. We withdrew our kids from most activities outside school. We socialized less. All our trips became impromptu as we couldn’t really count on being able to stick to any plans.
“I don’t think about her day-to-day. But I often think about her when I am sad,” he continued, “So much has happened that it is even hard to imagine how our life would be if she were to suddenly come alive today and plop right back into our life.”
Life Goes On
When people die, it seems like a cliché to make the observation that ‘life goes on.’ When you’ve built a life with someone, it’s hard to imagine how life could go on without them. It feels profane to even approach that thought. But life goes on, not because of one big thing, but due to millions of little incidents, decisions, and memories.
Our kids have now lived about one-third of their lives – our son, a bit less, and our daughter, a bit more – without their mother. In these five years (over 1800 days!) we have made countless memories without Uzma. Meals, after-school activities, birthday parties, movies, vacations, game nights, conversations, holidays, walks…so many memories. So many decisions. All without Uzma.
At first, whenever faced with any decision about the kids – when they should have a smartphone, for example – I found myself thinking about what she would have said based on our talks. But as time went by, I realized that I was on my own. There were so many decisions about kids that parents don’t talk about ahead of time because we don’t assume one of us will die before facing that decision together. Often, talking aloud with each other brings us to conclusions far from where we begin. Without those talks, one has to figure things out on one’s own and process things with other trusted voices.
Life goes on…but with a twist. When grief suddenly resurfaces, it is raw and biting.
The Bouncing Ball of Grief
A few years ago, a Twitter user shared the bouncing ball analogy of grief. Imagine a box that represents our life. A ball inside that box represents grief. There’s a red button on the inside of one of the box’s walls. Whenever the grief ball touches the red button, it causes immense pain and sadness. In the immediate aftermath of a loss, that ball is enormous, occupying almost the entire box and brushing against the red button at every attempt to move.
In the original analogy, over time, the ball grows smaller. It bounces off the walls of the box of life without hitting the button as frequently as before. But when it does hit the button, the pain and sadness are just as intense as they were in the beginning.
While the analogy resonates with me, I think the ball does not change in size. It only appears smaller because the box grows with all those countless daily moments of living life. Life goes on.
Memory Is Recorded, Then Built
A friend told Uzma, in what was to be her final year, “Make videos of yourself for your kids. Leave little messages for them about your hopes and dreams. Tell them you love them.” Now and again, I wonder how our memories of her would be had she followed that advice.
With the wondrous devices that our smartphones are, it is all too easy to make such videos memorializing oneself for loved ones. Uzma could have created hundreds of videos allowing her to choose how our kids would remember her. But she never made a single one with the explicit goal of helping shape the kids’ memories.
“I want the kids to build their memory of me, not receive frozen memories as inheritance,” she said.
While our memories may begin as mental recordings, they eventually become stories. How we see ourselves and how we want to see ourselves shape the details we remember, misremember, and simply forget. The warm feeling accompanying nostalgia depends on forgetting our past’s bad and sad parts. This selective forgetting is a feature, not a bug, of our mind. As opposable thumbs make our species infinitely adaptable in the physical realm, our tendency to shape our memories makes us versatile in the emotional sphere, allowing us to live well in the present instead of dwelling in the past.
Uzma wanted our kids to be adaptable and resilient. She believed that those videos would get in the way of them being able to shape their memories of Mom. She didn’t want to be a ghostly presence telling them things from a time and emotional space that would no longer exist. And so much about our world changed since she died.
Sometimes acquaintances ask our son, “How’s chess?” He tells them he no longer plays chess. He quit not long after Uzma died. He also quit playing the trombone. But now, he runs for his school. He has board game nights with his old friends. But he has new friends whom Uzma never knew, with whom he does other things that bring him joy. He has Uzma’s knack for cutting to the chase and speaking from his heart.
Our daughter, who has Uzma’s memory for faces and love of art, picked up the trumpet after Uzma died. She, too, has new friends, with whom she has various shared interests. She sings. She plays basketball. She used to be scared of dogs. But she is now the closest to the goldendoodle we welcomed into our family just before COVID. And that dog brings so much joy to our home.
Life expands. Life goes on.
Yet, She Lives
When someone becomes part of your soul, you don’t have to miss them every day to remember them. This is even more so for kids who have lost a parent after having built memories with them. Uzma comes up in conversations in our home about all sorts of things. About foods she used to cook, things she enjoyed, the wisdom she shared, where she worked, how she lived, how she died. Once a year we go online together and make a donation in her name to the local cancer charity where she volunteered.
David Eagleman says in the book Sum: Forty Tales from the Afterlives, “There are three deaths. The first is when the body ceases to function. The second is when the body is consigned to the grave. The third is that moment, sometime in the future, when your name is spoken for the last time.”
This past summer, Iqbal, a wise and affectionate friend, invited us to dinner. As we were about to leave, Iqbal, who also knew Uzma, hugged the three of us and reminded us, “You know, as long as we speak her name, Uzma lives among us. So, let’s speak her name together.” The four of us looked to the sky and roared as loudly as we could without bothering other diners at the restaurant, “Uzma! Uzma! Uzma!”
Most people are not surprised to learn that the kids and I are in counseling since their mother, my wife Uzma, died almost a year and a half ago. Some people are, however, surprised that a psychiatrist would need counseling.
Will we need counseling? I wrestled with this question for a few months before Uzma died. When Uzma’s cancer came back as stage 4, both of us knew we were unlikely to grow old together. The diagnosis of stage 4 cancer instantaneously brings the end of life in one’s field of vision. If it happens after a period of remission, one stops being a survivor and becomes an impending mortality statistic. Each passing day, each failed treatment moves death from the periphery to a more central position in one’s mind. It casts an ominous shadow on every part of one’s life.
Many of those who love a person with stage 4 cancer start experiencing elements of grief long before that person breathes her last. Beginning to mourn for a near-certain loss before the loss happens is called anticipatory grief. I am not sure that we should continue calling such sorrow “anticipatory.” Often a death from cancer — and some other debilitating chronic illnesses — is preceded by a parade of losses, some of which I wrote about in Cost Of Cancer:
…Travel to and from the clinic where the patient receives treatment adds to the burden of illness. There are lost wages – for the patient, and also for any family member(s) or friends(s) who accompany her to various treatments. Families often have to struggle to find time to plan and cook meals. They end up eating more frozen or restaurant meals, which are less healthy and more expensive than home-cooked meals. Since Stage 4 patients will be in treatment for the rest of their lives, there’s no end to all this.
Stage 4 cancer didn’t just spread through Uzma’s liver. It spread throughout her life, our life. We have supportive friends and family, but it was as if cancer threw a noose around our life and slowly but steadily kept tightening it. Our social and professional life constricted during treatment…
The longer a person lives with stage 4 cancer, the more those short-of-death losses keep piling on. I have come to believe that to some degree, what we call “anticipatory” grief, in reality, is the mourning for losses that have already begun — injuries that are warning of an even more devastating loss.
What will I learn from a counselor or therapist that I don’t already know? I asked myself this question when thinking of counseling. Indeed, I have helped bereaved individuals in my work. I probably know at least as much about overcoming loss and grief as most mental health professionals. Nevertheless, in the circumstances like these, it’s not the knowledge that is faulty, but its application. The heart makes it difficult for the head to remain objective when one has to treat oneself, or one’s loved ones. As Sir William Osler, one of the wisest physicians who ever lived said:
A physician who treats himself has a fool for a patient.
Our kids and I were about to experience two significant losses — my wife and their mother. Though some psychologists rate the death of a spouse as the most stressful event a person can experience, I find it difficult to imagine any loss harder a child losing a parent. It has the potential to permanently derail the road to the development of a stable sense of self, which is essential for both happiness and success in life.
Listen to Stephen Colbert and Anderson Cooper talk about the effect of losing their fathers at ten years old. (If you play and don’t skip ahead the video will automatically stop playing at 4:07). They describe the impact of the loss of a parent in ways similar to how I have heard patients describe it:
Transcript: :
And you’ve spoken very publicly about what you experienced as a kid. And I just, a lot of it I didn’t know. I think a lot of people don’t know. So if you don’t mind, I wanted to talk to you a little about it and sort of how it has shaped who you are now?
Your dad was killed in a plane crash. You were 10 years old along with your two brothers, Peter and Paul. And they were the closest brothers to you in age.
Stephen Colbert: Right, it goes Jimmy, Eddie, Mary, Billy and Margo, Tommy, Jay, Lulu, Paul, Peter, Steven.
Anderson Cooper: 11 are there?
Colbert: I’m the youngest of 11.
Cooper: All right. My dad died when I was 10, too. It is such a horrible age to lose a father. I can’t imagine losing both my brothers at the same time as well. For me, losing my dad then, it changed the trajectory in my life.
I’m a different person than I feel like I was meant to be. And I feel like there are times I, yes, I’m, I feel like I remember when I was 10, I felt like I marked time. To this day I mark time between while my dad was alive and after. It is like the New Year zero. It’s like when Pol Pot took over Cambodia[empahsis mine].
Colbert: Without a doubt. Without a doubt. Yes. There’s another guy. There is another Steve. There is a Steve Colbert there is that kid before my father and brothers died. And it is kind of difficult. I have fairly vivid memories from right after they died to the present. It’s continuous and contiguous you know like it is all connected. There is a big break in the cable of my memory at their death. Everything before that has an odd ghostly–
Cooper: Like shards of glass. Like flashes.
Colbert: Little bits of it and then the thing that, really like music because they died in September. They died on September 11th, 1974. The music from that summer leading up to it I will undo me in an instant.
The song of the summer was band on the run. Do not play band on the run around me. Yes. You become a different person like I was just personally shattered. And then you kind of re-form yourself in this quiet, grieving world that was created in the house.
And my mother had me to take care of, which I think was sort of a gift for her, it was a sense of purpose at that point because I was the last child. But I also had her to take care of. It became a very quiet house and very dark.
And ordinary concerns of childhood suddenly disappeared. I won’t say mature because that actually was kind of delayed by the death of my father, by restarting at 10. But I had a different point of view than the children around me[emphasis mine].
Cooper: There was a writer, Mary Gordon, who wrote about fatherless girls and I think it applies and my mom used to quote it to me all the time but I think it applies to boys as well as paraphrase. A fatherless child thinks all things possible and nothing is safe. And I never really understood when my mom would say when I was alone, young but I’ve come to understand it.
All skilled mental health professionals regularly practice managing the impact of their own emotions on their treatment relationships. That, however, does not make us superhuman. In our roles as husbands, parents, children, siblings, and friends, we remain just as capable of acting on our petty and sublime feelings as our patients. Grief can emotionally paralyze grown men and women, let alone children. Growing up motherless is not easy for kids, but what would their fate be if their father were to succumb to grief? No child can survive the emotional impact of losing their mother to cancer and their father, even if not literally, at the same time.
It was a high-probability, high-risk scenario.
That’s why I decided that we would all go to grief counseling. And that is why I only waited a couple of weeks after Uzma’s death before setting up our first appointment.
I loved the movie O’Brother Where Art Thou. There are a couple of related scenes from that movie that came to mind recently. For those who haven’t seen the movie, it’s set in the south — Mississippi, I think — during the Great Depression. Three escaped convicts, with the authorities in hot pursuit, end up at the farm owned by a cousin of one of the three men. As they are sitting at the kitchen table eating, one of them asks his farmer cousin about where his wife is. The farmer glances at his son sitting across, then back to his cousin. He first says something to the effect that he doesn’t know. Then, in a matter-of-fact manner, he adds, “Mrs. Hogwallop up and r-u-n-n-o-f-t.” We can see that he is trying to protect his son from the devastating truth about the young one’s mother.
A couple of scenes later, when the authorities have the convicts surrounded at the farm, the young boy comes driving the family car and offers to help the convicts escape again. And he says, “Get in boys. I am gonna r-u-n-n-o-f-t!”
Suddenly the audience realizes that the kid knows more than his father thinks he knows.
I am reminded of this scene every time I am with friends and relatives who try to speak of Uzma in hushed tones when the kids are within earshot. They think they are protecting our kids by not making them think of their loss. Like the father in the movie, they are well-intentioned. But they just don’t get it.
Our children saw their mother live with cancer. They saw how she chose to live life fully despite her illness. She made many new friends in her last few years. She wrote a blog. She wrote a book. She was a model for a nationwide beauty store chain. They saw all that.
When Uzma was around, she was the one who first greeted them when they returned home from school. When she was well, it was she who took them clothes shopping. She cooked their favorite meals. She arranged their playdates. She nursed them when they were sick.
Then they saw their mother gradually become weak. She stopped doing most of the things she used to do for them. They saw her become unable to climb stairs, bathe, use the bathroom, and even get into her bed on her own. They were next to her when she breathed her last. They lay next to her for several minutes before the funeral home staff came to take her away. They felt her get cold and stiff. The saw and felt her die.
Whispers and hushed tones are for secrets, especially shameful ones. Uzma’s death is not a shameful secret that must be whispered about.
The way she lived it and the way she died is burned in my and our kids’ memories. Whether we speak of her every day or do not speak of her for months is irrelevant to us missing her. How is it possible that not speaking about her in our kids’ presence will make them feel their loss any less than her daily absence does?
There’s no shame in loss, no guilt in grief, and no embarrassment in mourning. And let’s not make our kids think so.
The other day, about 3 weeks after we buried Uzma, I was getting a haircut at the neighborhood barber’s. The friendly guy that he is, he asks, “So, what’s new?”
Do I tell him Uzma died? Do I not? I decide not to dwell on the question too long. A pregnant pause with one’s barber at this point would be weird. In a split second, I reply, as if instinctively, “Not much. How about you?”
He starts telling me of the vacation he is planning with his family for summer. My mind wanders off.
I have forgotten how to plan vacations this far ahead. The last time we planned a vacation, staycation or even a weekend trip months ahead was a while ago; looking back at Uzma’s stage 4 cancer journey, it seems like a lifetime ago. Most of our trips in the previous few years have been last-minute adventures. If Uzma’s condition and treatment were stable close to some break coming up for the kids, we would go. “I should also start making plans now,” I tell myself, “so that once again we can start getting whatever qualifies as a bargain these days for air tickets.”
How do we decide who to tell and when to remain silent about a calamity that has befallen us? I’m not sure there are any rules for this. Will people know what to say? Will they become uncomfortable?
Will they say something irritating like, “You’ve got to be strong for the kids.”
As if I don’t know that!
Or will they say another common line, “At least she is not in pain any longer.”
}Yeah, that’s because she is dead! Is that better? I feel like asking.
But I don’t. I don’t want to make them uncomfortable. Some people will say, “I am sorry for your loss. I wish I could do something that would ease your pain. I am here for you.” When said sincerely, especially by someone who you know will check in on you soon, those sentences have an intriguing soothing power.
In the South Asian community, Uzma and I often heard of and from people who didn’t share their cancer diagnosis even with close friends. Sometimes, not even with close family members. We would often wonder what that was about. Why the stigma about something no one could accuse you of bringing upon yourself? After all, cancer is not like a mental illness whose victim can be casually and cruelly blamed for bringing suffering upon herself. It couldn’t be blamed on a lack of willpower. Uzma believed it had to do with the practice of arranged marriage in our community. If it became widely known that a parent had cancer, her son or daughter might be shunned when it’s time to search for a bride or groom. I don’t know if that is the reason, but it seems as good as any.
Uzma did not hide her suffering. She shared it. She hoped to inspire more people to share and be open about their cancer so that all could learn from each other. Sharing brought incredible emotional support from both friends, old and new. Not just to her, but also to her family. Whatever she gave of herself, she got in return many times over.
I am not sure about the term “Facebook friends.” It is often used with some disdain. But I’ve seen Uzma form meaningful emotional connections with people she has never met in person. When you do that, isn’t a Facebook friend just a real friend we haven’t yet met?
Hospice staff encouraged us to tell the kids’ schools about Mom being in hospice. We did. I also told the schools when Uzma passed away. I let the parents of the kids’ closest friends know. “Who else can we tell?” some asked. “Tell whoever you think would want to know,” I said.
I am glad I did. Many of our children’s friends came to the funeral with their families. Some of their teachers came too. Our kids felt incredibly supported. Many friends offered condolences in their own way when they went back to school. But one boy kept telling our daughter that he didn’t believe that her mother had died. That it was a lie. That little twerp, I thought. But he was the exception.
“How do you like it?” asked the barber as he handed me a mirror so I could see how he had cut my hair on the back of my head. It was fine. I paid him, tipped him, made some small talk, and left.
That evening, I resumed my train of thought, how should I have responded to that question, “What’s new?”
Obviously, a lot is new.
Uzma is not around.
I am a single parent, the only breadwinner, not just the primary one.
I am no longer one member of a team of two responsible for the physical and emotional well-being of our kids; I am the team. All family decisions, big and small — from what to cook tonight, to which dishwasher to buy to replace the one that just broke, to the kids’ education, are now mine alone.
Soon, Uzma’s name will no longer appear on various financial accounts, tax returns, and even return address labels. It won’t be on travel itineraries. Until our son grows up a bit more, I will have to get used to being the only one driving the family around, with an empty seat next to me. She won’t be there on her birthday, on Mother’s Day, on the kids’ birthdays. All that, and much more, is new.
I am glad I didn’t unload all this on the barber. If only he knew the bullet he dodged! So who should we tell, and who should we leave alone? I am sure there’s no one single approach. I could take the path of looking back at my last meeting with a person and recalling whether she asked about Uzma then. Uzma’s existence had to have mattered to them for her non-existence to matter.
Clear-cut this approach might be, but it would be antithetical to Uzma’s attitude, from which I could learn a lot. Her stance was one of openness to new emotional connections. After much reflection, I have decided that my rule of thumb will be to share my loss with anyone if the setting is conducive to active listening. A barbershop is not, so it was still okay that I replied, “Not much.”
