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centerforloss.com
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Transcript for this episode:
Kwadwo: 00:37 Heather Bousada, welcome to the podcast. Thank you very much. Um, do you remember how we met? Gosh, that was a long time ago. Long time ago. Cause if you off the hook, I don't actually remember how we met, but I do remember how I met your husband. So to the listener, I was playing hockey game and he, he didn't know, he didn't know who I was and I, I approached him after the game after a hard fought game, which I think we won by the way. You guys were dirty. We were done. And I approached Chris and I said, Hey, I know your wife. And he's like, what did you just say to me? Oh I really know your wife.
Heather: 01:31 And then he did recognize you. Yeah. And that I explained that to everybody in the teleconference one. Yes. Unknowingly.
Kwadwo: 01:40 Well thanks for doing this Heather. It means a lot. And so maybe we could start off with what does a day in the life of the Heather Bousada look like, whether it's at the hospital doing what you do or in your work with grief.
Heather: 01:57 Yeah. Uh, well it's busy. It's very busy, but, uh, most of my time spent in the palliative care and the palliative care team and I also work in medicine and I've worked with you in ICU, but, uh, I, you know, my love and passion is palliative care and grief. So a lot of my days spent with the palliative care team, meeting families and patients and talking about terminal illness and impact it has on the family and their goals and their hopes and their dreams and basically what's happened to them and providing them support through that very difficult time
Kwadwo: 02:32 and crazy hours long days is that
Heather: 02:36 they're long days, they're long days. And sometimes I walk out of here pulling my hair and other times I'm like, wow, I feel like I was able to make a difference, you know? And that feels good. Yeah,
Kwadwo: 02:45 absolutely. One thing that I do appreciate that you guys do is, you know, I run into, I'll have a family meeting or two in the afternoon and I feel emotionally I'd, no, I actually just physically, emotionally and physically exhausted. You're doing this every day.
Heather: 03:05 Yeah. Well we all are in healthcare, aren't we? We're having really difficult conversations all the time. I don't think, I think, uh, one of my colleagues I was talks about if we only had a GoPro, I don't think people would believe what we go through in a day in terms of the conversations that we have. They're really detailed. Intimate people are at their worst times often, right? And trying to make really serious decisions, um, on, not sometimes for themselves, but oftentimes families are having to make that for their loved one and they, they're not sure what to do when they're feeling stressed and scared and they're not understanding how, or, you know, looking for support. And feeling in a world that's not part of their typical day. Right? Yeah.
Kwadwo: 03:49 Imagine you literally can't imagine being in the spots that and, right. Like, it's not something that you think about, dream about, it's just,
Heather: 03:58 well, people don't get practice at this right now, let's say to people like, it's not something you sign up for. And then all of a sudden you find yourself in the hospital having to have conversations about end of life, either for yourself or your family. And it's, it's a, it's, you don't get practice at it. Right? Yeah.
Kwadwo: 04:15 So we'll talk about some of the details of, you know, these difficult conversations in a bit, but you have a expertise in grief counseling and what are some of the things that you wish more people knew about the grieving process?
Heather: 04:34 Yeah, that's a, it's a huge topic. You know, it's, it is my passion and not only for patients and families, but expecially for health care providers. You know, one of my passions lately is that, uh, as healers, we need to be okay, right? We need to, we're doing some really serious work here. And if we're not understanding, you know, for having to go through our own grief and mourning through loss of a family member, you know, I see it all the time, I see at the hospital and people are coming to me and you know, oftentimes they feel like what is going on. You know, I used to be able to take care of five, 10 people. Now all of a sudden just taking care of one person, I feel like completely overwrought and I don't know what's going on with me. Right. And sometimes just having conversation about what it is and what's happening to them, to their body, to their mind, um, really kind of helps take off.
Heather: 05:21 Oh, OK. Cause we're not only a death denying culture, but we really, um, you know, there's that whole, whether it's implicit or explicit out there that you got to buck up, right? You got to buck up, you got to get on with it. Um, you know, have a stiff upper lip and you know, people are looked at as courageous if, Oh, they look so strong. They haven't even cried. Not everybody cries, but there's that sense of, you know, if you're only being strong, if you're, you know, just keep moving forward. But the interesting part about grief and mourning is it's not about moving forward. Everything we do in grief and mourning is about going backwards. So I mean, if you look at grief and mourning, and I think that's an important part, I, well one I want to start with a lot of my approach degree from morning is from dr Alan Wolfelt.
Heather: 06:06 He has a companion and approach and that's where my training is from. Um, as a social worker, I've also, I've gone down, there's a center for loss and life transitions and it's actually really a wonderful approach. And I, I heard dr Wolfville years ago and you know, just working in this field, I, when he talked about what grief and mourning as in going from the head to the heart, really it was what it's about. And it's that, um, that journey that we experienced that it just resonated with me, but it's throughout our system, right? So like if you look at brief families or the hospices, the Canadian military, the American military, they have also adopted this approach because it's a, it's meeting people not from the head and the intellect. It's meeting people with the heart, right? It's companioning somebody and companion is means to break bread and it's like sitting down with somebody and actually saying, you know what, I'm not necessarily the expert in what your relationship was with that person or what you went through, but I have some tools and I have an open, compassionate heart to be able to explore. What was that loss like for you? Right.
Kwadwo: 07:11 I feel like that's a big fear for a lot of people. It's like when you know somebody has experienced a loss, I can't count how many times people say, I do not know what to say to them. I do not know what to do. I don't know what to bring. I, you know, it's, it's awkward for awkward for some people, some people, and even as a palliative care doc that in certain circumstances where it's like, you know, I literally, I'm not sure what to tell this person.
Heather: 07:41 Yeah. And there's actually, we can talk about that a little bit later, but I think it's important to start off with like, you know, there's a lot of jargon out there, you know, brave man grief, mourning, like people throw out the words, right? But it's really, it's important to understand what the concepts mean, right? So that you can make some sense of it. So when you're looking at at, for instance, bereavement, it's a loss of a loved one. But what, what's really fascinating about the word is it actually means that the Latin root word of it means to be torn apart. So, um, you know, it's amazing whether it's here or people would call me when I was doing my private practice with grief counseling and in some shape or form, they would be describing that their world has been blown apart. Right. Um, and that's basically what it is, is that your world's been torn apart.
Heather: 08:28 But the, the, the grief is important cause it's the grief is there are internal thoughts and feelings. So unless you're a sociopath, you're gonna feel that loss, right? When you love somebody, I mean, grief and love are the flip side of the same coin, right? Cause if you love somebody, you're gonna feel that loss. So it's the thoughts and feelings. But where we get stuck is people just have that feeling, right? They have that feeling, but they're not sure. So they're not sure how to process it. Right? And we don't get taught that and everybody's teaching them to, Oh, just move on. Right? But where the real work is in the morning, right? And that's the part that, um, that I tried to help people understand and, and how to kind of go about doing that. Like the morning is the outward expression of that grief.
Heather: 09:11 So emotions need motion. Um, so the more that you, it's a social, a shared response to loss. Sometimes it can be specific to one's culture or rituals that you might do. But unless you're sharing that loss and expressing it and um, and I see it all the time with patients and families, once you get them to start talking about that relationship and who that person was, you can see the movement, right? It's a natural unfolding. You know, people think of it as like mental health. It's grief and mourning is a natural thing that we all go through, right? Unfortunately we like to avoid pain and suffering, but we will experience it and it can't get people around it. You got to go through it. But in that journey is as a really kind of beauty in it in terms of recognizing what you've experienced and how you then integrate it. I mean, grief is, if you really look at it, it's, it's moving from one of physical presence, um, to one of memory. That's the ultimate shift that what you're doing in the morning work, right? So again, you're moving that from physical presence to one American memory and you're integrating that into your new life, right? There is no new norm. There's a new normal now, right? You can't go back to the old normal as a new normal. So you're integrating that.
Kwadwo: 10:28 Wow. So there's a lot there. So one thing actually, so Heather maybe talk a bit about what to expect when you're going through that process. Yeah. Obviously there's going to be a lot of distraught pain, you know, there's that new normal as you described, but what are some of the things that people might expect?
Heather: 10:57 Yeah. Like for yourself and other people. Yeah, and that's what I find fascinating is um, people don't understand, like people think, assume it's a, it's just an emotional response, right? But it's the totality of your whole being, right? It affects you physically, cognitively, socially as spiritual ritually. And especially if, if I make reference to the healthcare workers, we need to be game on, right? So like as yourself, as an ICU doctor, you need to be there. You need to be present. But if you're going through a lot, us, you are, um, not only physically your body, you get extreme fatigue. Uh, you exhausted your appetite. You know, 80% of people lose their appetite, 10% gain another 10% that are neutral sleep disturbance. You know, so often people will tell me, you know, they're quick to go to bed to sleep cause they're so exhausted, but they wake up frequently, right?
Heather: 11:53 Um, so you're not getting a lot of sleep. Your immune system's down, right? Cause you're in this critical state, like you're in this hyper arousal because you've got this in either an impending loss or a loss, right? So, um, physically it's affecting you emotionally. You've got like multitude. There's no, you can find many different feelings at once and it comes in waves, right? Um, and cognitive is, it was interesting part, especially with healthcare is that healthcare workers is you, you know, we multitask, right? We're constantly multitasking and, and life and death. Like you're making life and death decisions. Um, and you all of a sudden you're, and it's, there's a lot of research on it and uh, people will start to, uh, you'll find it's difficult to concentrate. Um, it more irritable. Uh, the multitasking often goes right out the window. Um, so all of a sudden you're like, wow, you know what's, and that's where people often in healthcare come to me and say, I don't know what's going on, but you know, I was used to, I would could do this with my eyes closed.
Heather: 12:54 Now I can't even, um, you know, concentrate on, on two patients that I have. Um, I mean I, for a personal example, I remember I've been in palliative care like for 19 years and I remember when my own mom was, um, uh, terminally ill and she was in the hospital and I went with my team to go meet a patient and the doctor and the nurse and myself when we sat down. And sometimes you're not aware of it, right? Cause you're so in grossed and what's happening that you're not really aware of how difficult it is for you. So I remember sitting there listening to the nurse and the doctor talked to the patient a conversation I have every day and I couldn't even process what they were saying. At least I had the wherewithal to go, wow, I shouldn't be here. Yeah, I need to step back.
Heather: 13:42 And, and I did, I stepped back. I mean it cause it's cognitive that couldn't wrap my brain around it. Like what was going on, what was being said. Um, yeah. And this was fairly recent. Oh, about four years ago. Yeah. Um, and uh, recently with my dad. But uh, yeah, it, it, uh, it's, it's good to recognize it. Right? It's important for, uh, for people in general, but especially for healthcare workers that they're not doing a bad job. That there's nothing wrong with them. They're going to the natural processes of grieving. Right. Yeah. We talked a bit about this beforehand. It's a very unique scenario for health care providers to try and take care of others. Yeah. You definitely, yeah. You know, like for the reasons you mentioned prior about how unique it is for health care workers, you're literally taking care of people. You're seeing death and dying every, yeah.
Kwadwo:
