Twice now I have been exposed to the fact that school guidance counselors are trained in the 5 stages of grief for handling grief with children. Whether or not it’s helpful, I really resist this description of grief as a process, so much so that I am not even going to talk about the 5 stages. Instead, I’d like to replace it with something I found on the internet by Michelle Devine:

Here are some things to remember:

• There is no finish line. This is not a race. Grief has its own lifespan, unique to you.

• There is no time when pain and grief are completed; you grieve because you love and love is part of you. Love changes, but does not end.

• What will happen, what can happen, as you allow your grief, is that you will move differently with pain. It shifts and changes: sometimes heavy, sometimes light.

• Anger will happen. So will fear, peace, joy, guilt, confusion, and a range of other things. You will flash back and forth through many feelings, often several of them at once.

• Sometimes you will be tired of grief. You will turn away. And you’ll turn back. And you’ll turn away. Grief has a rhythm of its own.

• Grief can be absolutely crazy-making. This does not mean you are crazy.

• There is no way to do grief “wrong.” It may be painful, but it is never wrong.

Remember that there is no “closure.” Grief is part of love, and love evolves. Even acceptance is not final: It continuously shifts and changes.

The truth is, you will seize up in the face of pain and soften into it, again and again, both things in rapid succession, and both things with silence in between. You’ll find ways to live inside your grief, and in doing so, it will find its own right place.

One thing I’d like to add from my experience is that grief does end. And it doesn’t end. It’s both. I’d also like to point out that the word grief in the quote above could naturally be replaced by a multitude of words– love, growth, birth, life…

After two and half years, I googled pulmonary embolism. An embolus is any mass in the bloodstream, including fat, air, blood clot and tumor. Thrombus refers specifically to a blood clots in the blood vessels. My understanding is that it is normal to always have some amount of tiny blood clots floating in the blood stream; basically, they are starters for injuries. A pulmonary embolism means that a large embolism is blocking a pulmonary artery. A pulmonary thrombo embolism means that the large embolism is a blood clot. Most people are familiar with a pulmonary embolism beginning as a deep vein thrombosis. That is, for some reason, all of the tiny emboli congregate together in a vein and eventually the larger blood clot makes its way to an artery. As far as I know there was no evidence of a DVT in Matt’s case. What I remember the doctor in the ER telling me was that he had many many, too many small emboli in his lungs.

I also looked up statistics on pulmonary embolisms. Most of the data involves pulmonary embolisms caused by DVT because there are a lot of cases that go undiagnosed. About 600,000 people in the U.S. are affected by PE each year, and maybe 100,000 die. 25% of deaths are sudden with no symptoms, but the majority of cases go more than a month with symptoms. I found that pulmonary embolism is quite common as a serious health condition and it used to go undiagnosed for a very large percentage of the people who suffered from it. With more technology, things have swung in the opposite direction and it is now considered to be over diagnosed. What makes it difficult to diagnose is that the primary symptom is shortness of breath. Supposedly 5-8% of Americans are genetically predisposed to having a pulmonary embolism.

I still find it inexplicable that Matt did not talk about suspecting a blood clot. I never googled pulmonary embolism till now, but knowing him, he must have done it at some point after his mother died of the condition. I know I thought that pulmonary embolism meant a DVT in a person’s leg. Maybe he thought the same thing. Or maybe he pushed the idea aside because he had gone to the hospital one time years before complaining of a DVT that was a false alarm. I’m not interested in studying how things might have happened differently. But I realized that I do have to come to terms with the fact that I will probably never know how and why Matt’s body declined from running 25 miles a week to such a critical condition.