"Our soul must perform two duties. The one is that we must reverently wonder and be surprised. The other is that we must gently let go and let be." Julian of Norwich

...Cancer teaches both!!!

Thursday, July 29, 2010

Stages of Grief - Elisabeth Kubler Ross

I first started working with Kubler-Ross's "stages of grief" back when I began my life as a minister in Port Simpson in 1992.  I've returned to it often and still find it to be a helpful way of understanding grief and loss.  Kubler-Ross dedicated her life to working with the dying, the ill, the lost, and the bereaved.  She has left a great legacy of wisdom.  Wisdom which is helpful when "Living on The Edge".

The following interpretation is with thanks to Alan Chapman. 

Five Stages of Grief
(Based on the Grief Cycle model first published in On Death & Dying, Elisabeth Kübler-Ross, 1969. Interpretation by Alan Chapman 2006-2009.)

            Also known as the 'grief cycle', it is important to bear in mind that Kübler-Ross did not intend this to be a rigid series of sequential or uniformly timed steps. It's not a process as such, it's a model or a framework. There is a subtle difference: a process implies something quite fixed and consistent; a model is less specific - more of a shape or guide. By way of example, people do not always experience all of the five 'grief cycle' stages. Some stages might be revisited. Some stages might not be experienced at all. Transition between stages can be more of an ebb and flow, rather than a progression. The five stages are not linear; neither are they equal in their experience. People's grief, and other reactions to emotional trauma, are as individual as a fingerprint.
            The model recognizes that people have to pass through their own individual journey of coming to terms with death and bereavement, etc., after which there is generally an acceptance of reality, which then enables the person to cope.
            Again, while Kübler-Ross's focus was on death and bereavement, the grief cycle model is a useful perspective for understanding our own and other people's emotional reaction to personal trauma and change, irrespective of cause. 

1 - Denial         
Denial is a conscious or unconscious refusal to accept facts, information, reality, etc., relating to the situation concerned. It's a defense mechanism and perfectly natural. Some people can become locked in this stage when dealing with a traumatic change that can be ignored. Death of course is not particularly easy to avoid or evade indefinitely.

2 - Anger          
Anger can manifest in different ways. People dealing with emotional upset can be angry with themselves, and/or with others, especially those close to them. Knowing this helps keep us detached and non-judgmental when experiencing the anger of someone who is very upset.

3 - Bargaining              
Traditionally the bargaining stage for people facing death can involve attempting to bargain with whatever God the person believes in. People facing less serious trauma can bargain or seek to negotiate a compromise. For example "Can we still be friends?.." when facing a break-up. Bargaining rarely provides a sustainable solution, especially if it's a matter of life or death.

4 - Depression             
Also referred to as preparatory grieving. In a way it's the dress rehearsal or the practice run for the 'aftermath' although this stage means different things depending on whom it involves. It's a sort of acceptance with emotional attachment. It's natural to feel sadness and regret, fear, uncertainty, etc. It shows that the person has at least begun to accept the reality.

5 - Acceptance             
Again this stage definitely varies according to the person's situation, although broadly it is an indication that there is some emotional detachment and objectivity. People dying can enter this stage a long time before the people they leave behind, who must necessarily pass through their own individual stages of dealing with the grief.

(Based on the Grief Cycle model first published in On Death & Dying, Elisabeth Kübler-Ross, 1969.  Interpretation by Alan Chapman 2006-2009.)


Personally, I live in and out of all of these places, and more, on a regular basis.  My cancer journey began in August 2004 with a diagnosis of stage 4 colon cancer, I've had a couple of serious recurrences, and now live with a persistent and painful presence of cancer in my very bone.  Alas!  There seems to be no escaping it!  

Not to stay focused on the negative.  My journey has been, and continues to be, filled with many experiences of great joy, deep peace, and real hope.  These things go hand in hand with the otherwise "afflictive" emotions that together form the complex emotional climate of my heart and soul. I find that I can be more authentic in my experiences of the many good things in life when I am also honest and authentic with my very real grief. 

Peace and blessings... Rob; in Vancouver

"For those who seek to understand it, death is a highly creative force. 
The highest spiritual values of life can originate from the thought and study of death."
Elisabeth Kubler-Ross

Twenty Faces of Grief: Mitch Carmody


Mitch Carmody

Tuesday, July 27, 2010

Long-Term Disability

Recent changes in my medical situation have persuaded me to remain on "long-term" disability rather than return to work this Fall as initially hoped.  Increased pain in the sacrum, related neurological pain, and changes in my blood chemistry indicate that the cancer is still alive and well.  Rats!

Dr. Klimo has resumed treatment with Irinotecan in addition to the Erbitux in hopes that it will provide a measure of relief.  So far it seems to be helping on the pain front. Naseau, fatigue, and diarrhea are again, however, the order of the day.   At this stage of the game it is amazing how important pain relief can become.  There is nothing more mentally disabling than chronic pain, as many of you who live with it know.

I will have an opportunity to bring closure to my pastoral relationship with St. Stephen's, and my life as a minister, at a couple of services this Fall.  We are tentatively planning a farewell service for October 3rd.  The day before my birthday and the feast of St. Francis, which suits me very well!

After that we will be heading to Edmonton to celebrate Robyn's marriage to Brandon on 10-10-10.

Peace and blessings...  Rob

"The only disability in life is a bad attitude."
Scott Hamilton

Tuesday, July 13, 2010

Death Awareness

David Kuhl is a Vancouver doctor, researcher, and the author of "What Dying People Want: Practical Wisdom for the End of Life".   David's book is based on research that he did with people who were living with a terminal illness.  "David Kuhl has peeled back the cover on the inner experience of living with dying. What Dying People Want synthesizes the wisdom of ancient mythology and insights from depth psychology with real-life perspectives of people living in the long shadow of death.  Kuhl's message is brimming with hope.  This book has relevance for us all."  Ira Byock. M.D. author of "Dying Well"

In his book David speaks of "time and anxiety" and suggests the following exercise as a way coming to grips with the proximity of death in our lives.

Instructions:  Adapted from “What Dying People Want” by David Kuhl pp 29-30
  1. Think of the line above as representing your lifetime. Place an X on the line to show where you believe you are at present. Once you have done this take note of your feelings. Do you have a sense of relief? Of anxiety? Of fear? What else comes up for you?
  2. Think of six significant events in your life. Number these events 1 through 6 and place the numbers on the line. Again, take note of your emotions as you recall these events.
  3. Consider the line between X and DEATH. How would you like to live this period? Is there anything special you would like to do? Choose six significant events that you would like to “fit in” before the end of your life. Number these events 1 through 6, and place the numbers on the line.
I have worked with this exercise twice now since I was diagnosed. Once in the Fall of 2004 and again this Summer.  On each occasion I have found myself placing the X fairly near to the end of the line.  I have found it helpful each time, both in assessing what has been important in my life and in determining how to live with what time I have left.  It is interesting for me to note that I have now lived much longer than what I had anticipated shortly after my diagnosis in 2004.

There have been times during the past 6 years where I have enjoyed the sense of a much longer "future horizon".   These were times when I was able to make plans and commitments that went years into the future.  Whilst in the midst of lengthy periods of remission I have even believed, at times, that I might live out a normal life-span.  Regrettably this is much less so now.  With each recurrence I am jolted back to reality and made to realize again that "life is short"!

David asks his readers to imagine a scenario where you have just learned that you have a terminal illness and only 6 to 12 months left to live.  You now place an X very near to the end of the life-line above.  He then asks... 
  1. Would you live differently?   
  2. Starting when?   
  3. Would you care as much what other people think about you or about what you do, how you live?   
  4. How would you fill your time?
    Good questions!

    Peace and blessings... Rob; in Vancouver

    "Life is short.  And we do not have long to gladden the hearts of those who walk the way with us.  So let us be swift to love.  And let us make haste to show kindness." Henri Amiel

    Sunday, July 11, 2010

    The Underwear Affair!

     Yesterday we took part in the "Underwear Affair".  A very fun, fund-raising run/walk for research for cancers "below the belt"; colon, prostrate, ovarian, bladder, etc.   Our team, "The Energy Train",  included  Morgan and Brent; Kelly, Jerome, and Shea;  Pam and I; Jill and Brandi from Pam's office; and Brandi's cousin Miranda.

    A great time was had by all!

    Our team has raised almost $4000 so far!  We are still accepting donations so if you haven't had the chance to give yet please do so.  Just hit the link to the right and choose the team member you would like to sponsor.  Your support helps us to uncover the cure! 

    BTW... Pam, Morgan and I finished 291, 292, 293 in a field of 311!  YEAH!  We would have turned in a better time but I spent too much time taking pictures of all the pretty girls!!

    Have a very great day!

    Rob; in Vancouver

    "Medical science has proven time and again 
    that when the resources are provided, 
    great progress in the treatment, cure, 
    and prevention of disease can occur."
    Michael J. Fox

    Saturday, July 3, 2010


    Thank you all who have sponsored me in the "Underwear Affair".  With your help I have now reached my $1000 goal!  YEAH!  Cancer is being beaten!

    But Pam still needs help in making her goal so if you haven't made a donation yet but would still like to you can visit her site and sponsor her.   Just click the flashing underwear link above.

    Thank you for helping to find a cure for cancer!

    Love Rob and Pam; in Vancouver