Harry is a 12 year old boy, small in stature, quiet, whose sister died in a car accident last month when another car jumped the median. His sister is described as a charismatic, smart and involved sibling and child. She had finished college and had begun working in her chosen field, living with Harry and their parents in the meantime, saving her money for a while before getting her own apartment. Harry's parents are, understandably, devastated. Harry, quiet, struggled with how to articulate his feelings at Dawn's death. I asked him about his religious beliefs and he began to discuss his basic understanding about the afterlife, consistent with his religious upbringing. It quickly became clear that his religious education had been thorough, but that this was one of those topics that called for a deeper review of the family's religious doctrine. He wondered whether God was punishing Dawn, was this some Divine retribution for her behavior - though he admitted she was a great sister whom everyone loved. Maybe, he wondered, he and his family were being punished for something - what, he didn't know. Maybe there is no God at all? How do we find meaning in this tragic and senseless loss of life? These are questions that are normal, human and very difficult to answer. Harry's parents, tearfully, are rallying with him to find meaning in something that admittedly does not easily make sense. As we all know, the lessons Harry is learning are those that we all learn one day or another. Painful, but a normal part of human development.
Susie is a 10 year old girl who came to see me due to tantrums that began about a month ago, seemingly out of the blue. She has High Functioning Autism (Asperger's) and has until now been a lovely young lady, her "little professor" presentation not withstanding. It was mentioned in passing that her mom underwent a fairly routine surgery last fall that had unexpected consequences and ended up with complications that took a couple of months to resolve. It was serious, but she was never in danger of death per her physician. Susie was told that all was OK and had no follow up questions about her mom's status. They went around their business, her mother recovered fully and all was well. Until the tantrums began.
As Susie, her dad and mom and I spoke, I learned that her mom's recovery hadn't really finished until about a month before the tantrums began. I asked Susie whether she thought her mom was near death. Not only did she say yes, but she feared that throughout mom's recovery (at home) that mom might at any second, die, inaccurately extrapolating that the tenderness mom had at her surgical site when she came home was permanent, an everlasting vulnerability through which her mom could die. She also stated that she feared she could have the same need for the same surgery her mom needed and that feared dying from it. Her parents' eyes grew wide.
The good news for Susie is that she's smart. We immediately began the education process, having learned that her silence upon being told that her mom's surgery was not as simple as hoped, did not mean she fully understood her mother's prognosis. Her parents understood that they would need to be on guard as to any connection between Susie's behavior and other issues and engaged her multiple times afterwords in discussing what she really understood about lots of things, physical health being high on the list. Two weeks later, Susie came back and the tantrums had stopped. Cold.
Mortality is very hard for us to understand.
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