Grief, mindfulness, and changing the system

On Tuesday March 16, 2021, David Gass, my love and life partner left our house to drop off his car to be serviced. The radio was playing, the coffee pot was hot, his leather gloves were waiting at the top of the stairs because he would be back in 30 minutes after a pleasant walk through the Halifax, NS, streets. He never came back. A man driving a pick-up truck ran David down in a crosswalk. After 3 days of unconsciousness in the intensive care unit, with family beside him 24 hours each day, he died, peacefully, in my arms.

Carried by a tsunami of loss, I am now on a foreign shore where everything is both familiar and completely strange. I understand in a daily, visceral way the universal human experience of profound loss.

I know in this turbulent year many of you are experiencing losses, from small to life changing. I have found over the past weeks that the steady flow of cards, kind words, flowers, poems, sharing of experiences, books, thoughtful gifts, telephone calls, messages, and e-mails from family, friends, and strangers are comforting and healing. I offer you my reflections in the hope they might be helpful.

I was fortunate to hear Dr Jillian Horton speak on May 1, 2021, at the Northern Ontario School of Medicine in Sudbury for the Northern Constellations Faculty Development workshop. Among the helpful and wise things she said, this stood out to me: “As physicians we may devalue our own suffering (someone else’s is always worse). Suffering doesn’t have to be the worst for it to matter.” Even though we know many people and patients whose struggles are much more difficult than ours, we can practise self compassion to acknowledge and ease our own pain.

Many of you know and appreciate David as a mentor, colleague, friend, family medicine leader, and pillar of the CFPC since the 1980s. His life’s work was to make health care systems better, largely through advancing and improving family medicine. I have asked myself over the past weeks—how can loss and grief lead to systemic change? The death of a cherished family member can galvanize us into action. Our family began asking questions: was David’s death a banal and random event? No, the intersection where he was hit was known to be dangerous. And in all our cities, towns, and rural and remote communities, cars driven by people, kill other people. Many municipal designs, policies, and structures prioritize the convenience of cars over the safety of people who walk and bike. How many cars and trucks kill pedestrians and cyclists every year in your community, province, or territory? And we know that coronavirus disease 2019 has killed many cherished family members across Canada, disproportionately those who already suffer from neglect or oppression in our racist, ageist, ableist, and sexist systems.

Mindfulness can support systemic change. To quote Horton again, “My ‘a-ha’ moment: mindfulness practices can help achieve system change because they change us … and we are the people who have to be able to withstand the system for long enough to change it.”

I need a mindfulness practice to counter the fear and anger I feel every day as I walk in Halifax, hating every pickup truck, double checking for left turners at every intersection, wondering how David felt in that moment when the truck hit him. The antidote for me is to consciously and deliberately find and focus on something small and beautiful in every house, every garden that I pass, in each of the trees that line the streets, in the light on the water. This allows me to hold in my heart the understanding that the world will always be both terrible and beautiful.

Because June is national Indigenous month, I want to end by acknowledging that however devastating this personal loss is, as a white, affluent, well-educated person, there are struggles, pain, and trauma I will not experience because my privilege protects me. And I continue to admire and respect the resilience and life-giving teachings that I have received from Indigenous Elders, most recently at Northern Constellations, where Perry McLeod-Shabogesic led a virtual sunrise ceremony. I learned from Perry that as the light from the sun spreads over the land we can pause and be grateful for the new day, a chance to do better than we did yesterday and to realize that this day is what we have as none of us is guaranteed tomorrow.

My heart goes out to you if you are experiencing loss or losses in these complex, difficult times. I hope you have support and kindness around you. I would recommend mindfulness practices. My hope and commitment is that as family doctors we can work together through the provincial chapters and the national College to create the systemic changes Canadians need—more Patient’s Medical Home and neighbourhoods, easier access to family doctors, comprehensive care closer to home, and safer and healthier communities for all.

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