Throughout my writing, you will notice I frequently talk about grief, even when I am not referring to losing someone. Grief comes in many forms - the loss of a loved one, the loss of a job, moving, loss of relationship, changing schools.  Transitions often usher in feelings of grief as we try to figure out how to navigate into what will be our new normal.  Learning how to deal with transition means recognizing that “the way things were” is now different and calls for us to learn how we will be in this new phase of our life.

Some of us thrive on change -  approaching new situations with curiosity and expectation that things will work out just fine and we will adjust.  Some of us fear the unknowns of change.  We may not have had to deal with a lot of changes in our life, so we have no practice, no map for how to move forward. Or perhaps the changes we have experienced were frightening, overwhelming, out of our control and we are left feeling unable to cope, so when change presents itself, we freeze, or we leave, or we seek comfort in silence. 

Learning how we deal with transition, how we grieve letting go of that which is familiar and precious, opens us to approaching what is to come, even when what is coming is hard.

When we are dealing with illness, ours or someone we love, what often prevents us from having some of the hard conversations we need to have is fear, fueled by unresolved grief that has become a part of our “hard wiring,” our automatic response. 

And so it begins…

Dear Patient,

When you have just learned of a new diagnosis and you don't know what's to come or how it will impact your life, you may be frozen in that moment. You don’t know what to ask. You are not sure how to weigh your options for treatment. You don't know how this is going to impact you or those around you.  You wonder how your literal existence is going to change, how your needs will change. You want to know “what will it look like - this new path I am on – all of it - including the outcome...”  This is where your mind goes in the first five minutes of hearing a diagnosis. 

And then you think about those around you.  “How is this going to change who I am to others and how will others see me? Will they look at me the same way and expect things from me that I may not be able to do.  Will they stop asking me for things because they think I can no longer be the person they know me to be? Will there be support at those times when I ask for it.  And what about the times when I don't think I need anything but I really do?”

Whether it is a chronic treatable illness, like COPD or CHF or HIV, Parkinson’s, or life-limiting such as some cancers, ALS or Alzheimer’s, life moving forward will be changed.  These are palliative conversations – big picture, what’s-to-come – to have with providers and the folks in your life who will accompany you. You wouldn’t go on a trip without planning.  Your life deserves the same attention, even if the “landmarks” are uncertain.

This is not a journey to go alone.  Enter friend, relative, loved one – someone who can come with you, ask questions and take notes.  Whether it's that follow up appointment with your primary physician who needs to ”talk to you about your lab results,”  or you are meeting with the specialist, take someone with you.  Respect that taking in big news is a transition and you may as well start gathering your committee of support.