"Normal will never happen again"

The author of two books about coping with sudden death talks about the emotional fallout of losing someone without having had a chance to say goodbye.

By Douglas Cruickshank

Published September 9, 2002 7:03PM (EDT)

In October 1997, a bee stung Brook Noel's 27-year-old brother, Caleb, a professional athlete. Neither he nor anyone else in his family was aware that he was severely allergic to bee stings. He went into anaphylactic shock and died the same day. In the days that followed, trying to grapple with the trauma of losing her brother, Noel went looking for a book that would help her cope. "There was nothing on sudden death," she says. "It was all on terminal illness."

So she wrote a book herself. The publication of "I Wasn't Ready to Say Goodbye: Surviving, Coping and Healing After the Sudden Death of a Loved One," coauthored with Pamela D. Blair, led to media attention. Later, five months prior to the 9/11 attacks, Noel was asked to join the 48-member Family Support Team of the National Air Disaster Alliance.

When the planes were hijacked on 9/11, Noel was away from her Milwaukee home, in Chicago on business. "The first call I made was to find out if we were needed, and if so, where," she says. "Because of the inability to fly from one place to another, they took people [on the NADA support team] who could get there by car.

"I went to work on the phone -- calling organizations; faxing informational sheets about how you can help someone who's grieving; sending free copies of the book, pamphlets and brochures to the Red Cross and all the support centers. Then I started taking calls. I did a lot of shows that broadcast directly to New York -- Bloomberg Radio and ABC. That really opened up the network of people who came to me looking for help. I was available 24/7 as a volunteer for as long as I was needed. I also donated all the proceeds from the book to the WTC fund."

Noel just finished a second book about coping with death, "GriefSteps: 10 Steps for Moving Forward After Loss," scheduled for release this fall. She's the founder of Champion Press, which publishes her books among others, and she recently launched the GriefSteps Web site.

"What I wanted to do was bring a free volunteer support network into the home, one that people could access at any time they need it," she says. "Anyone is welcome. All over the world. We use e-mail [people can write in and receive direct answers to questions], a message board, and we moderate everything. We also do support chats -- I host each of those -- for anyone that wants to talk."

Noel's advice to those who lose someone in a sudden death is to forget anything they may have heard about the right way to grieve and to make a point of finding out everything about that person's death that they can. After such a tragedy, "our inclination is to give people a time period and insist they should adapt within that period, then go back to their normal functioning. And that can't happen," she says. "Normal as they knew it will never happen again."

Recently I spoke with Noel about 9/11; how men, women and children deal differently with a sudden death; and how media coverage of tragic events affects our ability to come to grips with them.

You're often one of the first people to talk with someone who's lost a person close to them due to a sudden death. What's the first thing you say?

The first thing I say is "You will get through this." And that's the most important thing you can say to someone in that situation because they truly don't believe they can. The second thing I tell them is that this is just as if you'd had triple bypass surgery: You're going to need time to recover physically and emotionally. Whatever anyone tells you, disregard it: There's no right or wrong way to grieve. It's a long road. There's no timeline. You need to take it slow.

In the case of sudden deaths, and it's certainly come up with the 9/11 tragedy, some have a hard time understanding the emphasis on finding any remnant no matter how small, whether it's a wedding ring, a wristwatch, a scrap of clothing -- anything like that to return to the families. Why is that so important?

Belief factor. Again, it's something you'd never thought you'd experience. And until you see it, hold it, feel it, it isn't real. [People may believe that] the longer you can prevent yourself from having to come into direct contact with the experience, the less it's going to hurt. We saw that with 9/11. For how many days after we'd hit the point where no one could be alive did they continue looking for survivors? Everybody just kept holding on. To me, that got to be a bit unhealthy. The country was in denial.

What's the effect of directly witnessing a sudden death? This happened, of course, on 9/11. Have you worked with people who are dealing with that kind of shock?

Yes. Of course, when they witness it, there's the "Why them, not me?" because they were obviously physically close enough that they were almost there. They experience all those questions, the feelings and values of that moment, much more intensely than a person who was not present.

I believe that the biggest challenge there, of course, is the visual image. To hear about death is one thing; to see death is a whole different thing. And we see this in wars all the time -- these people come back that have seen it and have survived and what that does to them psychologically.

Post-traumatic stress?

Yes. And so you begin to move into more cases where you're having the post-traumatic stress disorders and the general anxiety, the clinical mental depression, the major depressive episodes, because just as joyous as it is to see a birth -- you know how exciting that is for people -- it's just as intense when someone leaves the world. Just as you'd never forget the birth of your child, you'll never forget seeing someone die.

That stage is an entire category of grieving. Many times those people who see that -- for example, if you take bystanders that were on the street when the WTC buildings collapsed -- will tell you that they would have rather been in the building than lived after seeing what they saw.

One of the true gifts of going through the experience is, when you get to the point where you've moved through many of the stages of grief -- when you're, say, 18 months out -- is that you can see life in a different way than everyone around you. You truly see the value of a moment more than anyone else. That's probably the greatest gift that you can glean from these experiences, but a lot of people don't get to that stage.

People reassess their lives, sometimes people make radical changes. Do these changes last, or do they tend to go back to their old ways after a few months?

Normally, the changes are so radical you cannot go back to your old ways. For example, you might move. You might say, "Since I'm not with my husband anymore, I don't want to be in this house with these memories." Or you may change jobs.

As for the social element, it depends on the situation. Often when you lose someone, especially a spouse, your entire social status changes. If you were friends with other couples, you may find that they'll no longer be in your inner circle of friends -- primarily because most people are uncomfortable with death and they will not know how to respond to you, and you will often be uncomfortable with them because it reminds you of the fact that, say, you're there without your husband.

One of the things that is so important [to realize] is that normal does not exist anymore for these people [who've lost someone suddenly]. Normal as they knew it will never happen again. And humans aren't very good with permanent changes like that and understanding them, so our inclination is to give people a time period and insist they should adapt within that period, then go back to their normal functioning. And that can't happen.

I call it the "10 days syndrome." You see it in the media: Something happens, it's covered intensely for 10 days. It's just like that with the bereaved. You lose someone, the first 10 days you'll receive more phone calls, more visitors, more food than you ever thought existed in the world. But during those first 10 days you are fully in shock and will barely remember anything that happened.

Then somewhere around the 11th or 12th day, your body begins to let in some of the facts of what has happened. When you experience this loss you become almost catatonic. Your body shuts down because it can't accept that information. Then, as you're ready to assimilate it, once you get to that point, almost everybody else is gone -- they've moved on. Now you're ready and you need help and there's no one there.

And the aloneness really starts to sink in.

Yes. One of the most important things that people can do for someone who goes through this -- if they themselves can't do it, they should find a network or create one; two or three people -- is ensure that someone is with them constantly from day one, coming in every three to four hours and just checking on them. That way when they get to the stage where they're ready to talk about what happened, they have someone who shared it with them.

Are there ways of responding to sudden death and coping with the aftermath that are especially typical of Americans?

Yes, there are probably two things that you see most often. One is you see the active grievers, and these are the people that -- like the NYC widows of firefighters group -- have lost someone and the next thing they're doing is building an organization to help the people around them. And it's very important to actually address that a little bit -- that is a healthy way to grieve. For example, myself, I wrote a book. I wanted to take this awful experience and find a way to bring something out of it. The problem with that is if you get overconsumed.

Too much deflection of feeling?

Yes. You begin to use that as a device to not deal with your grief -- instead you help everyone else. But you never resolve your own issues.

Have you found that religious conviction makes a difference? Do people who have a deep religious faith find it any easier to deal with this experience?

It's very divided. Many people who are religious get very angry at God or whatever they believe the higher power is. You have some people that their faith does comfort them; you also have a lot of people who are not religious who find religion through the sudden death of a loved one.

I talked with one of the widows of a fireman from 9/11. She called me and related that her husband had always been religious and she hadn't been. She told me that based on the things that had happened, the support that had come to her, my book finding her, she was now convinced that there were angels. She had become religious through this experience.

You also find that there are many spiritual things that happen when you lose someone. Some psychologists believe that our mind creates them, and other people believe this is actually a spirit connection. But many people report that they hear footsteps in an empty home. Or it can be a scent they associate with the person they've lost. The number of these experiences is incredible. Nine out of ten of the bereaved will experience something to that effect. Then you have to turn to whatever your belief system is for explanation.

How do men and women differ in the way they deal with a sudden death?

It goes along pretty much with all the stereotypes of communication. Men tend to need more space. They tend to want to go off into isolation, scream at the world, and work this through on their own. They often assume a lot of guilt, especially if they've lost a child or their wife, feeling that they should have been able to take care of things and they've failed to do their job. A lot of times that's subconscious, but it's still a driving factor. So they want to go away and try to solve this.

A woman wants support. She wants to talk, and talk, and talk some more. She has to get all this information out in order to assimilate and make sense of it. And of course, in couples -- you hear how many couples who lose a child end up divorcing -- that's one of the primary reasons they break up. The way they need support is so different, they can't offer it to one another.

How does the way children deal with the sudden death of someone close to them differ between a kid who is, say, 6, and a child who is 14 or 15?

A child of 6 really doesn't understand the concept of death yet. They are familiar with cartoons where a character falls off a cliff, then he's back on the next episode. So each time someone dies, they come back; when the princess dies, she's kissed and wakes up. They don't understand the permanence of death.

One of the challenges there, is that as they move through each phase of childhood -- preadolescence, the teenage years -- they have to reexperience the situation with their newfound knowledge; same with any major life change, like a divorce. They have to be allowed the space to go through it all again.

Often parents don't allow the child that space because the parent's already moved on -- "Why do we have to bring all this up again?" But children do need to reexperience it at every age. So I think the thing you're battling there is, of course, the permanence issue and the child's egocentric attitude: "This should have been within my control. Somehow I'm to blame."

Is it especially difficult in the case of a child who's, say, in the 18-to-22 age group, where they're right in the midst of making that separation from the parents, and so they're really starting to feel, "Well, I don't need my parents. I'm an adult" -- then, in fact, they suddenly lose a parent?

Yes, even if you lose your parents in midlife, it's that final connection; your foundation has been broken. They are not there at the end of the day. And during that [18- to 22-year-old] transition stage, that's often where you've come through all the fights and the arguments and you've learned to sometimes listen and respect your parents ... And there's not a person around who will not torture themselves with "If only ..."

That's a really important piece of the process. When you have a major illness there's a diagnosis, there's treatment, there's a failed treatment and there's a death. There's a beginning, there's a middle, and there's an end. And we think in cyclical ways: We're born, we go through life, and we die.

We think in narrative fashion. You're saying that completing the story is a crucial part of the grieving process?

Right. And what you need to do when you lose someone suddenly -- you may not have all the answers to their story, how the story played out -- you need to find out as much information as you can to form a beginning, a middle and an end. When you do that, you can begin to put away all the if-onlys.

What are some of the more unusual responses people have to a sudden death? Is becoming manic or behaving in some other seemingly inappropriate fashion a more common response than we might assume?

It happens a lot. One of the most difficult things after you lose someone is the first time you laugh. The first time you laugh, you're just jolted that you could actually laugh. You feel incredible waves of guilt.

The most common response -- you hit it right on the head -- is becoming manic. You will just run and occupy yourself to stay busy with every little task you can in order not to think.

You get hyper-efficient?

Yes, you overorganize and try to oversolve. These are all things we do to try and make sense of something that's nonsensical. One of the ways is that you become manic. Another is the exact opposite: You can become incredibly withdrawn to the point of not eating; you're not coming out; you might stay in bed for two weeks.

And another very common response, which many people don't realize, is there's actually a tendency to revert to a very primitive, almost an animal-like, state where you'll find yourself going outside and being very aggressive and making sounds like howls; it's a very primitive state. I can only come up with the explanation that because the loss is so deep it penetrates into very different parts of yourself.

On 9/11 there were a lot of people killed at the Pentagon and in the Pennsylvania crash as well, and those events have not gotten anywhere near the coverage of the WTC attack. It would seem that the loved ones of the people lost at those sites must be dealing with a very different set of circumstances, in that there's so much attention given to the WTC victims and yet their relatives are just as dead also due to a horrific event.

I've talked to people from the Pennsylvania crash: relatives and also other people who lost someone at the WTC; widowers who see Lisa Beamer at the Olympics, with the president -- and many feel as if she's a spokesperson, and many others feel as if she's taking away their room to grieve, too, that it should be all or nothing, their grief is just as important.

We don't know what really happened, and even with the tape and knowing that certain people were primarily involved [in trying to overpower the hijackers], I think it's important to recognize that probably at the end, everyone, or many people, had a hand in it. I think we can get so focused on the lead characters that we can forget all the other people that were probably supporting them. But that's only natural: How do you cover a story of 80 families instead of casting one person as the model to represent that tragedy?

Again, it's our affinity for creating a narrative to help us explain such things to ourselves, and that's very natural, but at some point we have to be respectful of the fact that we've hurt many people by following Lisa Beamer's story in People magazine -- the birth of her baby and everything was wonderful, but what about all the other families? A roundup might have been a better way to be respectful if that's the media's concern with the grieving process.

The intense media focus on an event such as the 9/11 attacks results in an extraordinary abundance of tragic images -- in magazines, on television, on the Web. In the case of TV and online news coverage, the 9/11 images, some extremely graphic, were seen over and over again. How does repeatedly viewing these images of carnage and death affect our ability to cope with such a tragedy?

I believe it actually assists us. The more information we have, the better we're going to be able to process it. I think that's why you see so many people glued to these events.

I think the reason people watch it is that they want to have an opinion, they want to understand it, and to do that they need information. Especially something like 9/11 -- the more you understood what happened, the people involved, you saw the faces, the more it gave you the pieces to decide, OK this is what happened and this is how it affects me and this is how I need to feel.

One of the most appropriate media responses to come out of the 9/11 tragedy continues to be the New York Times' superb series of profiles, "Portraits of Grief."

Yes, I think that's an incredible way, a very intelligent and respectful approach to how to cover this story, as well as anyone that's doing roundup pieces. This didn't affect one family or three families -- let's look at what really happened here and all the different situations and all the different backgrounds [of the victims and their families].

One of the things that amazed me in the initial reporting was how many of the employees were covered who were from the big firms, the brokerages and so forth. And I wondered, what about the janitorial staff? the dishwashers? Where were they? Why weren't they showing up in the news?

Douglas Cruickshank

Douglas Cruickshank is a senior writer for Salon. For more articles by Cruickshank, visit his archive.

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