(a chapter from my grief book)

What is a dream? We aren’t talking about the visions you have when you are sleeping. A dream is a highly desired aspiration; AND a dream can be something you didn’t even know you wanted. A dream can be something you just had a knowing about; an assumption of receiving or retaining like not being handicapped, having a future, being happy.

A dream is not a living breathing creature; however, it is a thing that can be lost. That loss is real and the grieving that follows is just as valid as it is for a person/pet. Grieving an unexpected loss such as paralysis, stroke, injury, dementia, or any loss of ability is just as devastating as grieving the loss of a dream come true such as a desired job, relationship, or situation.

I have taken care of patients that are newly paralyzed. It is heartbreaking. I am amazed at the grace some people have for their new situation in life. I would be pounding on the doors of Heaven, raging with my questions for God. Because I see people when their prognosis is fairly new and their life upheaval has just begun and is in the “working it out” phase I believe I catch them in the denial stage of grief. So many are just glad to be alive.

For the ones that are not in that sweet spot of gratitude, it is a dark place. Anger colors their existence in red and a future is unfathomable because of their desire to not be in their reality.

Someone who is given any life-altering diagnosis has their dreams, of how their life is going to be, shattered.

When a patient is told that their foot has to be amputated they aren’t devastated because they are in love with their metatarsals, their flat arches and their heels. They will miss their foot because they are not going to be whole. They will have to learn a new way of walking. What if they are never able to kick the ball back and forth with a grandchild, go hiking, wear cute shoes? What if their foot is just the beginning of losing body parts to amputation?

Loss involving the body, mind, or spirit follows the same grieving path as the loss of a loved one. It is the loss of perfect health and the future of which you had dreamed (knowingly or unconsciously).

Loss of a dream that you can acquire follows that grief path too. For a very long time I had a list of dreams I wanted to accomplish before I was 40. The top one was to own my own business. I became the owner of an assisted living when I was 39 and added a hospice to that when I was 40. I was over the moon. Not only was the basic dream of owning a business coming to fruition but it was my absolute favorite thing to do. Hospice is my calling.

Two and a half years later I had to close that business. All of my business decisions were made from the heart. Not a single one was made from my head. I opened the business with no extra money. Quite literally made payroll with credit cards for a couple of months. When you open a hospice you have to have so many players in place, all of your policies and procedures, billing, etc., before you can get your first patient and then you go about taking care of your patients which require all the above plus supplying medication, supplies, etc. that are included in their hospice diagnosis. Staff that you are paying include a medical director (MD), nurse, home health aide, social worker/bereavement counselor, administrator; and you also have a volunteer coordinator and at least one volunteer. You do this without being able to bill until the state decides to survey you. We got lucky and got a perfect survey within one month of opening so we didn’t go too long without being able to bill. We added more employees quickly: on-call nurse, billing/office person, more nurses, social workers, and home health aides. We were busy and our team was amazing. We did really good work. It felt blessed. I felt fortunate every day for the team that we had created and the patients we were able to serve.

Money, for me as the owner, was an issue from the get-go. We were over-staffed and they were over-paid. I gave away a lot of hospice care to patients with no insurance coverage. But I loved it all so much that I didn’t want to change anything. I made one really bad hire at the assisted living, and one at the hospice. Those poison apples took their toll and between the letting someone go, needing to let someone go; making one hugely bad personal decision, and the financial mess, I had to close the business.

It gutted me. There were so many layers to the loss. I grieved for my employees who were losing a job that they adored. I grieved at letting them down. I grieved for our patients and the hospice community losing us. I grieved for myself and the loss of people that I had thought were friends. I grieved for the huge mistakes I had made and how their ripple effects go on into today. I miss my business. I miss my friends. I miss being a person who hadn’t made those mistakes. I miss my oblivion. I don’t know for sure what stage of grief I am in. Most days acceptance but I can easily vacillate back and forth between that and anger. Anger at myself.

Dreams are powerful motivators. Some days your dreams are all you have. For some though, losing a dream can end that process for them. They become cynical and refuse to look forward at all; cynicism is a protective mechanism. Shattered dreams hurt and for some, putting themselves through that more than once is too much.

Dreams are incredibly personal things. No two persons’ are the same. One cannot tell another how to dream their dream. Therefore the loss will be completely individualized as well. Someone could have looked in on my situation and told me my dream was absurd, that I wasn’t prepared. Someone could also say it was just business and to get over feeling anything toward my patients and employees.

I could look at a patient who is newly paralyzed, diagnosed with something unwanted, just lost a limb, or has a prognosis of something miserable and tell them to get over it and move on. Tell them how lucky they are to be alive and compare them to some other situation far worse. But that would be cruel.

Dreams don’t work that way, they are developed within the scope of an individual and therefore their destruction will affect that soul entirely. This means grief will be just as personal.