Loss and Grief

Dr Thanh-Tam Pham - 11/9/2018



Most people have experienced the loss of a loved one in a lifetime and the pain is more intense depending on the degree of attachment toward the deceased or the unexpectedness of the loss such as sudden death.

High grief death is from a violent death, a suicide or the loss of a child. A low grief death is one that is expected for a long time such as that of an extremely elderly person with multiple medical problems. The depth of the pain you experience in grief is connected toyour degree of attachment to the person and how much he or she was integral toyour life, to your well-being.

Bereavement can be a time of despair and breakdown but it can be a time of new found strength and discovery of a meaning of life once the healing process is complete.

Mourning is usually experienced in three phases: shock and disbelief, full awareness of the loss, and recovery.

The four tasks that Worden (1982) claims are necessary are:

Task 1: Accept the reality of loss

Task2: Experience the pain of the grief

Task3: Adjust to an environment in which the deceased is missing

Task 4: Withdraw emotional energy from the deceased and reinvest it in other social activity without uncertainty or guilt


My personal experience:

I lost my husband in 2010 after three years of fighting against lung cancer. We were married in 1975 since we were medical students in Vietnam and during all those years of marriage, we were always together and we shared the same profession, the same interests and the same beliefs. He was always so strong physically and full of energy that most people could not keep up with him. But one day he was diagnosed to have lung cancer spreading to the pleura, although he never smoked in his life. This was a big shock to us all as he was the one who was responsible for the welfare of the family and he was the invincible one. He was the spokesman of the family and he dealt with all the problems relating to the outside world whereas I simply lived comfortably in his shadow. Being doctors we both knew that an inoperable lung cancer is a death sentence but he tried to fight courageously for 3 years with ongoing chemotherapy. My comfort zone was thus broken and I was terrified of living with all the responsibilities entrusted to me. I wished that I could exchange my life for his life if I could as I was more afraid of living than dying. Luckily we soon discovered Buddhism and we both found a new meaning of life and death, of impermanence and the cause of our sufferings are our attachments in this life. He found acceptance of his illness and peace in his mind pretty quickly but he most worried about me, how could I cope with all the responsibilities towards the family with 3 children still dependent and 2 elderly parents and to be able to maintain the 2 clinics by myself and be able to pay all the mortgages that we created previously in our buying spree.


In the middle of all this grief and anxiety, I was lucky that I could apply mindfulness in my everyday activities so I still could cope with the pressure of a full time doctor working in 2 different clinics. I was able to concentrate at the task in front of me without much distraction from my anxiety and sadness.

In his last year of illness, the cancer was spreading to his brain and he lost the ability to walk and was bedridden. It was a painful experience for him as he was used to be very active, always loved to travel to the countryside and the outback to photograph the beautiful landscape of Australia. When he lost the ability to eat and swallow, he was ready to go but I begged him to agree to have PEG feeding as I was not ready to lose him. I now realised that I was being selfish to think about my own loss and not about his physical suffering. Of course he agreed with everything I asked and he even promised all his after lives to be with me.

His death, even expected for 3 years, still came with a big shock. The first time in my life, I felt real pain and emptiness.

I received great support from my patients and sometimes I could not hold my tears when patients reminded me of how great and kind my husband was. A lot of patients started to talk about their own loss and I realised that there were so many people losing their husbands at a young age as well. I understand that I am not alone in my suffering and since then my heart is opening up to everyone and I become more compassionate to other people. If I asked “Why it happened to me? I felt upset and depressed. But if I asked “Why not me?” the answer is “Why not” as death can touch everyone young or old, good or bad, wealthy or poor…

The other thing that I realised was my husband accepted his fate but he mostly worried about the people he left behind. If I loved him, I had to fulfil his wishes and I had to be strong enough to shoulder all the responsibilities he left to me. I then promised to him that I would do whatever it took to perform the work for both of us so he could rest in peace. So grieving is not about forgetting my loved one but it is about remembering how lucky I was to have such a great person in my life and remember how I could make him happy if he was still here with me. This thought gave me more energy to go on. Someday I felt sad and lonely especially confronting with some tasks that I could not do by myself such as simple thing like hanging a picture on the wall … I could see then I was upset because I was being selfish thinking about my own loss, I lost someone to care for me, to support me in time of need, and I felt sorry for myself…

I also realised that even though my husband was gone but his presence is still within me. I am who I am because of him. He gave me the love of natural landscape, the love of the Australian Outback, and the love of photography. He also gave me the training and the energy to work from dawn to dusk as we used to go out to photograph landscape before sunrise and went home after sunset. I felt that I have now the energy for both of us to carry on  the work of 2 persons.

I also lost my father in August 2014 at the age of 96 after 8 months of bedridden illness and I had the advantage to be close to him and to look after him at night time after work. This helped with the grieving and healing process as I did what I could to give him comfort in his last days.


I recently heard the moving story of Arman Abrahimzadeh who was given the Young Australian of the Year Award 2016.  His mother was stabbed repeatedly by his father in front of 300 guests at a Persian function at the Adelaide Convention Centre in 2010 for being disobedient. The story is most tragic as Arman lost a loving mother and the father was a murderer and in just one night, the 3 children are left with no parents. He was able to recover from the great loss and adjusted his life and took care of his 2 younger sisters. For the love of his mother he was able to divert his energy to advocate for victims of domestic violence bybeing active in the White Ribbon Campaign. The children set up Zahra Foundation in 2015 in honour of their mother to provide support and financial assistance to cover costs for housing, food, medication and later help women take up education and training to find jobs.


Losing someone you love and care deeply is very painful and there is no right or wrong way of mourning and sometimes it may take years to recover.

In my opinion if you are able to remember your loved one and focus at what you can do to make he/she happy and forget about your own loss, you can concentrate in your everyday life activities and possibly divert your energy to some activities or join community groups to support other people in the honour of your loved one. Remember your loved one always wants you to be happy and not be depressed as well.

You may feel guilty or regret that you did not say or did not do or did not help enough to prolong the life of your loved one, but if you think about it, he/she would love you and forgive you any way so forgive yourself.

Your loved one is not lost forever as he/she is still present in yourself as your life and your personality were shaped or influenced indefinitely by him/her.

Remember everything is impermanent and the only truth in this life is everyone has to die sooner or later and you are not alone in your grief.