What does the word “suffering” mean to you? How would you use it in a sentence? How have you personally experienced it? I think the first thing we need to do, all of us, is be very clear that suffering does exist. If we are not honest about the reality of it, we will be unable to alleviate or reduce it. And please understand that especially for me who does not immediately reach for medication, medication is not always the answer to the suffering someone is experiencing.
I use this word a lot, especially when explaining my role as a hospice nurse. I always want to remove suffering from those who are dying, as well as those who are preparing to say goodbye. Suffering to me is not just physical though, I see many versions of suffering. Suffering represents pain, physical pain of course, but it can also be mental, spiritual, and emotional.
I listened to a fantastic podcast conversation with palliative care physician BJ Miller, and UCSF chaplain Naomi Saks, on the GeriPal podcast. (link below) I encourage you to listen to that as well, because their take on suffering, how we react to suffering, and how each person uniquely navigates suffering, is really well expressed. For the purpose of this blog, I will share how I feel about it, how I talk about it, and how I have worked through my own, which I have experienced a lot of.
I had a conversation with a family about their loved one who was days away from dying, helping them to accept that forcing food and water at this time would not be comforting or helpful in any way. Their main concern was not about him having more time or being stronger if fed and hydrated, which is what I usually experience, but instead it was about him suffering from starvation. I did my best to explain the way the body works when it begins to shut down, letting them know that from what I have witnessed, introducing food and water at this time could cause more discomfort, and make it harder for the body to let go. And then I said, “He is not suffering from starvation,” which I completely believe, but when they asked me, “how do you know for sure?” I did not have an answer.
It suddenly occurred to me that my idea of suffering, and someone else’s, especially someone who was watching their loved one die, looks very different. We cannot compare our different ideas about, opinions of, or experience with suffering, and we cannot tell someone else how to feel. In their opinion, he was suffering, and I had to respect that. I met them where they were, not where I wanted them to be, choosing not to repeat my opinion that he was not suffering. Instead, I did my best to reassure them that at this time of his dying process, he was not craving food, wishing he was eating, or starving, which they accepted. I was thankful for that, but it left me wanting to dive into this topic a little more, so that I can be of more comfort to those struggling with all the ways we live, die, and grieve. Note: this was before I listened to the podcast conversation.
When I look back at my life, I can very quickly list at least five moments when I felt deep suffering, none of these being physical. I have been emotionally and verbally abused, abandoned, lied to, cheated on, and I have said goodbye to so many people I love that I can’t even count them anymore, and the ache I have felt was so deep that nothing could comfort it. I have suffered. I have also experienced physical pain so horrible that I thought dying might be easier, and to be honest, the physical pain was equally as hard to work through as the emotional, spiritual, and mental pain I have experienced.
The conversation between BJ Miller and Naomie Saks really helped me to appreciate the many layers of suffering, which has also helped me to be a little more understanding toward others experiencing their own. I am reminded how different we all are and that we should never tell someone that they are not suffering, or compare ours to theirs, but more than that, I think we need to be better at being aware of how differently we all feel pain, and what that looks like uniquely.
I think it is important that when someone uses the word "suffering" to describe how they think another is feeling, that instead of doubting it, or perhaps correcting them, we ask them what that means to them. This will validate how they are feeling, letting them know we hear them, and I also believe that it will help us to respond in a way that can bring comfort.
As a hospice nurse, my approach to family members moving forward will be wrapped with a little more compassion, sensitivity, and awareness of the different ways each person views suffering. And I will also be a little gentler with myself by not putting so much pressure on myself to alleviate someone else's suffering, despite how hard I might try. I have felt guilt before, I have crumbled inside when I see the look on a family members' face when they feel that I am not reducing their person's suffering. I have to be kinder to myself as well. I am constantly learning.
xo
Gabby
The conversation between BJ Miller and Naomi Saks, "The Nature of Suffering" can be found at: https://geripal.org/the-nature-of-suffering-bj-miller-and-naomi-saks/
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