So Now What?

Many questions compete for attention when death comes and life changes. Among the many, there is at least one question that stubbornly remains as the numbness fades and our awareness of what has happened increases: So, now what?

Part of us knew this day was coming, but we tried not to think about it. Or at least not think about it all the time. Another part of us hoped for a miracle. Another part said, “Maybe they’re wrong.” Other parts took us to other places—other thoughts, other things to do, anything else. Who can live with every moment thinking of death? But now death has come. Snuck in through the cracks or walked right through the front door without knocking. It’s here and a life is not. No more breath, no more heartbeat. No words, no smiles, no pain, no struggle, no hugs. Now our special one has died. So now what?

Or maybe it wasn’t expected. Maybe yesterday was fine, last night, and this morning even. It happened quickly and without warning. A sudden pain in the chest. Knees buckling and to the floor. Someone ran the light or crossed the center line. A gunshot. Most of the time death gives us a “heads up,” but sometimes the only warnings we get are the everyday and routine reminders of our mortality—cuts and bruises, aches and pains, trips, falls, newspaper headlines and obituary pages. But on this day, on this night, it comes in a flash, lightning from a clear blue sky. We see it, but we can’t really believe it. It’s too much and too terrible. Too sad. Yet there it is, the horrible news and the body in its first day of permanent stillness. So now what?

Perhaps we keep the question at bay in the beginning. There are things to do. People to inform. Arrangements to make. Decisions about who, what, and when. Autopsy, organ or tissue donation, embalming, burial, cremation, clothes, flowers, food, money—so many money questions, insurance, his things, and “she would have wanted you to have that.” A seemingly endless list of things to think about and do, but only seemingly, really. Eventually, the list dwindles and the planned activities end. No more caregiving demands. No more funeral to plan. The tasks that can be quickly done are done. The house is quiet. The bed is empty. There’s an emptiness in our arms and heart. The stubborn question has surfaced and resurfaced repeatedly in past days or weeks, but we’ve had our “to-do” list instead. Now our list isn’t protecting us like it did before. We’re sitting alone and the question pulls up a chair. Leaning back with crossed arms or leaning in and taking our hands. So now what?

How can we know? Questions are so much easier than answers, and this “now what?” is a hard question. Is this a “true or false?” Multiple choice? All of the above or none of the above? No, it is the most-feared, least-liked, anxiety-king kind of question. It’s an essay question with a landscape of empty space to fill. It’s a nightmare.

But here’s some good news. We have time. We don’t have to answer all at once. It’s a big question and it will take time. We can write just a little—the little that we think we know—and then put the pen down to come back and write more later. No one says we’ve got to fill up the page all at once, and if anyone does say that, well, let’s just say they have a lot to learn.

Some more good news. We have all that space. If we want, we can do lots of things, old things and new things. We can do what we know is helpful because this is not the first time we’ve faced this kind of question. We can do things we’ve never done—try them on for size and see how they feel. Some of this and some of that. It’s a time for testing. We are certainly being tested, and we can also do our own testing to see what works best for us. Sometimes we don’t know until we try.

And one more piece of good news. We can change our minds. We can think we know “what now” and then learn we were wrong. When that happens, we pull out the big eraser or we just cross out those misguided parts, think it over, and write some more. We take more time, however it suits us, and we use more of that big space. We can forgive ourselves, apologize if needed, and give it another try.

Who says we have to get the answer exactly right the first time? Whoever says that also has more learning to do. Even if it’s us saying that, we can remember that we have time, we have space, and we can change our minds. And we can ask for help because, thank goodness, it’s a question on life’s open-book test. There are no rules against asking for help. What did you write on this one? Any suggestions from past experience? I’ve been thinking about…what do you think? Help and support are available.

So, now what? We take a breath, take a hand, take a knee, take some time—whatever we need. It’s a big question and it won’t (can’t) be answered all at once. But word by word, sentence by sentence, we will write, revise, and write some more. As we are ready, pen and paper, and as much space as we need, will be there for us.

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Greg Adams, LCSW, ACSW, FT
Program Coordinator
Center for Good Mourning
[email protected]

Other Voices 

How do we do find ways to grieve and mourn together with all the necessary safety limitations of a pandemic? These grieving families show us how it can be done. Continue Reading...

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In the Spotlight

Children often have questions about what happens to a body at a funeral home, but they don’t always voice those questions and adults are often not sure how to explain.

We have provided a “Mr. Rogers”-style video tour of a funeral home to help kids (and adults) understand. On our resources page, viewers can find the video under the section "Supporting a Grieving Child." Attention adults: Please preview before sharing with children. Watch Now

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Living All the Way

The following is from an essay and prayer from A Book of Prayer and Meditation:

"When my mother was dying of cancer, she and I prayed together a lot. The Bible says to “pray without ceasing,” she kept reminding me.
I remember the exact moment when she stopped praying to be healed and started praying for peace, la pè, her shorthand for a peaceful transition. We called those final prayers, our surrender prayers."
See More

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Particularly for Parents

"Grief is hard work. Staying connected with it and open to it requires trust in self."

After the death of a child, many parents struggle with feelings of guilt. Here is one bereaved mother’s experience with feeling guilt and experiencing forgiveness. See the first essay in this journal entitled "On Forgiveness."   Read More

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For Your Library

Early: An Intimate History of Premature Birth and What It Teaches Us About Being Human by Sarah DiGregorio, HarperCollins, 2020.

Unless we’ve had a premature baby or work in a Neonatal Intensive Care Unit (NICU), most of us don’t know very much about premature babies. We don’t know that the line of potential viability has dropped to, or been pushed to, around 23 weeks’ gestation. We don’t know that in 1903 (and for the next forty years), people paid to see premature babies in incubators being cared for by professional nurses at places like Coney Island—and that this was some of the best care available. That in the 1960s insurance would pay for the care of premature infants only if they lived fifteen days. That to survive, many premature babies not only need a ventilator but also a thing called surfactant to coat the inside of their lungs. Those who do know about premature babies know that experiences of racism in America lead to more premature births. They also understand that premature babies often need very intentional and special care after they leave the hospital to help them grow and thrive, yet many do not get this care.

Author Sarah DiGregorio didn’t know much about premature babies until she had one of her own. Her daughter survived and is thriving, but the experience was a harrowing one for baby and parents. Inspired by her experiences, DiGregorio set out to understand both the history of premature birth and its current realities. In her writing, she deftly integrates her personal story with historical accounts, current medical debates, and policy descriptions. She bravely illuminates and discusses hard questions related to viability, challenging decision-making, and when minimizing suffering can become the priority in a brief life. This is a significant summary and exploration of a world which impacts thousands of babies, families, and healthcare providers each year in the United States. A readable and much-appreciated resource for both health professionals and families.

Taking Questions

Facing the end of life, is it grief or is it depression? 

Distinguishing between a dying patient’s normal grief and a major depression is a part of care for patients near the end-of-life. This review helps us recognize what we're seeing so we can provide the right kind of support. 


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