Two takes on grief

Five days after her adult daughter was placed in a drug-induced coma in order to treat a raging infection, Joan Didion lost her husband. John Gregory Dunne, the writer with whom she had spent nearly every day of 39 years, died at the dinner table in the living room of their New York City apartment.

It was Dec. 30, 2003: They hadn’t even made it through Christmas week.

The two events, almost back to back, were overwhelming. In the weeks and months after John’s death, Didion knew she was sinking. Her usual survival technique -- reading everything she could about the subject -- wasn’t working: Despite her intellectual command of the grief literature (both literary and professional), in her heart of hearts she still expected her husband to come back.

As she writes in her memoir, “The Year of Magical Thinking,” that is why she did not read any of the obituaries written about John. And it is why she recoiled from the idea of disposing of his shoes (what would he have to wear on his feet when he returned?).

--

In this case, death was not unexpected

In March 2005, Eleanor Clift, a contributing editor at Newsweek, also experienced the death of her husband in their living room.

Tom Brazaitis, a longtime Washington, D.C., journalist, had been diagnosed with Stage 4 kidney cancer five years earlier. He had spent the last 10 weeks of his life in a hospital bed that hospice services had set up on the first floor of their home.

Clift has written a memoir of the couple’s experiences, “Two Weeks of Life: A Memoir of Love, Death and Politics,” which was released in March.

Unlike Didion, Clift was not blindsided by her husband’s death. She knew four months earlier, when Tom’s oncologist said they would take a break from chemotherapy, that he really meant they had run out of options.

Clift’s experiences provide a counterpoint to Didion’s in other ways: For one thing, Clift did not choose to immerse herself in the grief literature. Instead, she kept busy.

When I spoke with her in May, Clift told me, “There’s probably a category of people who handle grief with distraction, and I would fall in that category. I’m rarely psychologically unemployed . . . [Writing the book] helped me order my thoughts and, most importantly, filled in a big chunk of time -- 2 1/2 years.”

Didion seems to be a muller, a rehasher. Clift is a doer. Neither method of coping can be said to trump the other.

Two writers, two different styles of dealing with loss, and two very different sets of circumstances.

--

Loved one may be gone, but the feelings remain

In order not to be frozen in grief, we must be able to accept the fact of our loved one’s death. They are gone and they are not coming back. Here’s the problem: Although we have lost their physical presence, we have not lost our feelings for them, our sense that they are part of our lives, a yearning for their company. But if we don’t acknowledge the death, it is hard to do much with the feelings.

Didion’s inability to accept her husband’s death is strikingly portrayed in her memoir. Her protective fog of avoidance and denial did not begin to lift until six months after he died, and with good reason: Didion had other things to think about. Her daughter was not out of the woods.

Quintana was discharged from Beth Israel Medical Center on Jan. 22, 2004, but the weeks of immobility had caused other problems: On Jan. 25, she suffered a pulmonary embolism and was rushed to Columbia Presbyterian, where she was treated with anticoagulants.

By March, Quintana was healthy enough to attend her father’s belated memorial service and read a poem she had composed for him. Two days later, she and her husband took off for California. They had just landed at Los Angeles International Airport and were on their way to the car rental shuttle when Quintana collapsed with a brain bleed and had to be hospitalized at UCLA Medical Center.

Didion had to muster her strength and fly to Los Angeles, where she ensconced herself at the Beverly Wilshire. The family had lived in California for years, and the hotel served as an emotional sanctuary for Didion, an unbroken thread from earlier times.

Otherwise, she scrupulously avoided places from her past that would stir memories and create what she called a vortex. Still not able to confront her loss head-on, she had to navigate her way around it.

By the end of April, Quintana’s recovery was far enough along that Didion was able to have her transported back to New York for continuing rehabilitation.

By June, Didion was breathing more freely, and it was then that she made the decision to resume eating dinner in the living room where John had died. In August, she started using the Spode dinnerware that John’s mother had given him when he was still single. Didion was establishing, in small ways, new routines in her life that also maintained a bond with her husband.

The literature on grief speaks to this point.

K.M. Bennett was the lead investigator of a study of 91 surviving spouses in northwestern England, each of whom was interviewed for one to two hours about their current life and how well they had adapted to their loss.

The biggest tip-off about who had adapted well and who had not was what you might expect: The successful adapters were getting on with their lives. Also striking was their emotional state during the interview: They were appropriately sad at times, but not continuously distraught.

But Bennett was also struck by some of the more subtle signs of adaptation, such as maintaining bonds with the departed spouse. Although it was more true of the successful adapters, most of the survivors occasionally talked to their spouses as if they were still alive. As Bennett told me when I spoke with her in July, these were just everyday conversations. “Coming into your house and telling your dead spouse what you had done or, if you had lost something, appealing to them [for help]. Or simple things like saying good night.”

Clift clearly maintains a continuing bond with her husband. She still thinks about him every day and regards him as an important part of her life. Although she rarely talks directly to him, she will think about what his advice might be when she is puzzling out a problem.

And she does offer spoken thoughts to another Tom -- the cat the couple adopted from a local shelter, who came to them already tagged with her husband’s name.

--

Coping mechanism, or danger signal?

The issue of continuing bonds is an intriguing and nuanced one. Some bonds appear to be a sign of healthy coping, while others seem to indicate that the survivors are not getting on with their lives. Speaking of the latter category, Bennett shared her impression that widows who continue for an extended time to set a table for two were not doing well.

So why is putting out a plate and glass a sign of stuckness, while talking to a dead spouse can be benign, or even helpful?

The nuts and bolts of how successful grieving works are still being sorted out.

One way that mullers begin launching a new life is by reviewing their experiences of loss and trying to learn something positive from them. Usually this means gaining a new perspective on themselves or their relationships, or on life in general.

Didion made just such an attempt, but in the beginning she had a hard time getting traction.

When she had a checkup with her doctor in summer 2004, he asked how she was doing. She confided to him, “I just can’t see the upside in this.” Her doctor, who was also a family friend, later told her that he assumed she had misspoken, that what she meant to say was that she wasn’t yet able to see the light at the end of the tunnel.

No, she hadn’t misspoken. Like most mullers and rehashers, she tried to wrest from difficult events some sense of what she could take away from them. At that point, however, she just wasn’t coming up with anything.

--

Creative endeavors were born of grief

For both Clift and Didion, their continuing efforts to integrate their losses into their lives have played out in living postscripts.

Clift has become increasingly involved in the hospice movement and currently sits on the board of trustees of the National Hospice Foundation.

She recently gave a talk at the Politics and Prose bookstore in Washington, D.C. “At the end of it, Henry Hubbard, who used to work for Newsweek, came through the line and said, ‘Eleanor, you make hospice care sound so good, I can hardly wait.’ ”

When Didion’s book was released in October 2005, producer Scott Rudin approached her about writing a stage version.

The one-woman play (also called “The Year of Magical Thinking”) includes the death of Quintana -- a tragic coda not incorporated in the book.

The show ran in New York for about six months in 2007. In 2008, Vanessa Redgrave reprised the role at the National Theatre in London, with interspersed performances in Bath, Cheltenham and Dublin.

In 2009, U.S. theatergoers will be able to see the play in Boston; Seattle; Orlando, Fla.; and Washington, D.C.

In March 2007, the month it opened at New York’s Booth Theater, Didion wrote an essay for the New York Times about her decision to begin work on the play:

“I was seized by the idea that the fact that I had never written and did not know how to write a play could be the point, the imperative, the very reason to write one. My husband had died, our daughter had died, and I was no longer exactly the person I had been.”

--

Zanor is a practicing psychologist in Massachusetts.

health@latimes.com