Dealing with the death of a loved one can be one of the toughest things in life. Many individuals avoid seeking help from friends,family, or professional counseling. If you are finding it impossible to perform you daily living activities or have fallen into a depression, reach out for help before your condition deteriorates. You can overcome your painful loss.
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Pass it on,
Dr Anthony
This article titled “Coping with the death of a child” was written by Jon Henley, for The Guardian on Friday 14th October 2011 23.05 UTC
Billy Edwin Plowman Streeten died on 19 September 1995, aged two years and two months. That’s where we have to begin. No point trying to fudge things. It is, anyway, the reason this article is being written. Or at least, not Billy’s death itself, but the way people – family, friends, strangers, colleagues, his parents above all – dealt with it.
“It’s OK,” says Nicola Streeten, Billy’s mother. “Honestly, it’s completely fine. It was 16 years ago. We’re all right with it now. We realised then we were going through something huge, something absolutely massive, but we knew that eventually it would transform itself into something else, and it has. It’s OK. Really.”
Part of that monstrous experience has been transformed into a remarkable book, Billy, Me & You, published this month. A graphic novel, or more accurately a graphic memoir, drawn from the diary that Nicola kept, it is searchingly honest, and desperately sad at times. At others, it is genuinely very funny. Quite a feat.
“My motivation,” Nicola says, “was to tell a story people couldn’t put down. Not just about me, but questioning people’s responses, society’s response, to trauma and grief. I wanted the laughing and the crying. Not a misery memoir, a book for people who’ve had shit thrown at them. It may be cathartic for some, but for me it was a work of art. Not therapy.”
It would have been different if she’d done it at the time. We’re at her friend and editor’s house next to the British Museum in London. Nicola, 48 now, talks fast and laughs often. The day we meet is, by coincidence, the anniversary of Billy’s death; she and his father, her husband John, 58, have come to London from their Lincolnshire home and had their annual commemorative lunch together. (By the same token, they place a small notice in the Guardian every 19 September: “Our equivalent of putting flowers on his grave.”)
“We’re not at all religious,” Nicola says. “We couldn’t do God. So we kind of invented our own superstitious belief system. And part of that is, every year, we come to London for lunch on the day he died, and John puts the in memoriam in the paper.” But 16 years ago today, they were walking out of the Royal Brompton hospital, clutching their dead son’s possessions.
Billy was born when Nicola was 30. The couple were living in Crouch End, London; she teaching English as a foreign language, he an established artist. “It’s the greatest thing that can happen, when your baby’s born,” she says. “We just wanted to enjoy having a child. We shared the childcare from the start. Thank God – that meant we’d both had a fair innings.”
All Billy’s early tests had been fine; he was a normal baby. “Always on the bottom line of the graphs,” Nicola says, “but he never dropped off. We thought the doctors were being fussy. You never really know, though, do you, when it’s your first? You’re never really sure.”
When he was one, Billy got pneumonia and had to go to hospital for intravenous antibiotics. He recovered, but a shadow on his lung didn’t clear. “Over the next year, they ran every test,” says Nicola. “Cystic fibrosis, cancer, heart, the lot. And he was running around, fine. You could never have told.”
Eventually, a consultant at the Whittington hospital concluded it was asthma. That winter, Billy got ill a lot; coughs, colds, trips to the hospital, lots of medicine. In the summer, just after his second birthday in early July, the family booked a holiday cottage in Orkney. There Billy got really ill. “The doctor told us he needed an air ambulance, to Aberdeen,” Nicola says. “Billy couldn’t believe his luck: a helicopter!”
Back in London, his case was transferred to the Royal Brompton. There, suddenly, the experts announced: this isn’t asthma, this is heart-related. Three congenital deformities; Billy was suffering from pulmonary hypertension.
By early September, Nicola says: “They gave us our options. They could operate, in which case there was a 30% chance of success. They could try for a heart and lung transplant; not recommended. Or they could do nothing, in which case Billy would eventually die, slowly and painfully, because he would end up not being able to breathe.”
The options weren’t really options. “In any case, we’d latched on to the word ‘success’,” says Nicola. “Crazy, because you’d never get in a plane that had a 30% chance of landing safely. We all moved into the hospital, 10 days before. It was going to be a 15-hour op. In the evening, we went to the cinema. There were no mobile phones, of course, so I borrowed my sister’s pager. I was looking at it all through the film.”
Back at the hospital, Nicola and John were told the operation had been a success. Billy was in intensive care. “We were to go and get a good night’s sleep and have a leisurely breakfast,” Nicola says. “Then the next morning, when we got out of the lift, there were nurses running in the corridor. They put us in a waiting room. They said: ‘We’re so sorry.’ And we – extraordinary, isn’t it? – we said: ‘Thank you.’”
The scene after that moment, Nicola and John leaving the hospital, forms the opening page of Billy, Me & You. The book offers acutely observed snapshots of the couple through the decade and a half that follows: their savage grief, deep despair, dreams of suicide; the wildly differing reactions of those around them; Billy’s funeral; their return to work and, gradually, something resembling normality; group and individual therapy; the birth of their daughter Sally; the move to Lincolnshire; Nicola’s new career as an illustrator. It ends with a publisher taking a serious interest in Billy’s story.
The sum is probably more revealing – and certainly more affecting – about the experience of loss and grief than most self-help books. There are instants of crushing realisation (“Shall we go for dinner?” “A bit short notice for a babysitter … Oh yes!”) and of crucifying guilt (“Is it because I walked under ladders on purpose? Had an abortion when I was younger? Punishment from a God I don’t believe in?”).
Moments of dreadful self-doubt, too (“I’m not a mother … But I’m not not a mother … What am I?”); hopeless self-pity (“Nobody said anything to me about Billy … all day long”) and rage (“You want to put a bench in the park in Billy’s name? So I can sit there and watch everyone else’s alive children? Are you completely insensitive – or just an idiot?”) And moments of absurdity (Billy will be going to the crematorium, the funeral director tells them in hushed and Victorian tones, on the front seat of what we call “a hearsette”).
Nobody really tells you, says Nicola, about “the awful arrogance of grief. My capacity for intolerance, that was an eye-opener. I think you just felt like you have a … a licence to be foul to people. There we were, in the middle of this lovely north London suburban life, all parks and mortgages and good schools and organic food and pensions, and I just got so angry with everyone’s obsession with all this bourgeois, crappy stuff. Didn’t they realise how unimportant it all was, compared with what we’d been through?”
The couple spent a year, Nicola says, “very consciously working on it. Just hanging on … Grief and death affect everyone differently, of course. I was seriously worried that John might kill himself, really. We started therapy. I think we both knew very soon that our whole outlook on the world had changed. And then two years later, in 1997, Sally came along. There was life, after this. And things started to pick up.”
But there’s no limit to the extent of human awkwardness around death. Especially the death of a child. “My own pet hate,” says Nicola, “is when people say, ‘Oh yeah, John and Nicola – their baby died.’ Because Billy was a four-year block of my life: the thinking about him, the pregnancy, the two years he was alive, the solid year or more of grieving … That doesn’t feel like a baby, it really doesn’t.”
Struck by the different ways people reacted to her news, she started judging their responses, sometimes silently awarding marks out of 10. The worst, she says, were those who refused, for whatever reason, to acknowledge what had happened. “It could have been worse,” was bad; “Oh, really? My friend’s baby died too,” and “I can just imagine what you’re going through,” were pretty much the pits. Marginally better was “Would you like to come to dinner?” and “You must have another baby.” Best of all was: “I’m so sorry.”
An avid diary-keeper as a teenager, Nicola began writing one again soon after Billy died. She’s glad she did, if only because returning to those journals 13 years later, when she began working with her teenage daughter Sally on the magazine stories that would eventually become Billy, Me & You, she realised the tricks that memory plays.
“I cried every day, for a year,” she says. “In my memory, I only cried once. But it’s in my diaries, written down. Every day. I cried every single day, for a year. Looking back now, it’s clear we were pretty much mental for about five years.” (She didn’t cry once while she was working on this book, though: “It’s the most pleasurable thing I’ve done, about the worst thing that’s ever happened to me.”)
So what is Billy for her, today? There is a fair chance, had he lived, that he’d be starting his first term at university. “He’s there,” she says, “if he comes up. It’s no longer upsetting to talk about him. But he is locked in that moment, locked with us in that time. I can’t really project him into the future like that.”
John and Nicola have a cabinet of “old stuff” at home; a kind of informal archive. There’s a favourite bib of Billy’s; Nicola’s diaries; a milk bottle melted in some long-forgotten sterilisation process; Billy’s death certificate; Nicola’s successful pregnancy test; a letter published, two days after Billy died, in the Guardian’s Private Lives section, from a woman who had lost her baby daughter at three days. The reply that Nicola wrote, concluded: “There is nothing to say for the emptiness inside you, except that time will make the pain less acute.”
In any case, says Nicola, Sally is their focus now: “We wouldn’t want her to be overshadowed by a dead brother, whom she never met. Billy is a memory. But having this book, now, as a product of all that we went through … That’s nice.”
• Billy, Me & You by Nicola Streeten is published by Turnaround, £11.99. To order a copy for £9.59 with free UK p&p, go to guardian.co.uk/bookshop or call 0330 333 6846
guardian.co.uk © Guardian News & Media Limited 2010
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Why I’m off for some vitamin D – until the sun comes out
There’s has always been discussion on the pros and cons of vitamin supplementation in our diets. I see no harm in taking vitamin D and other supplements as long one stays within the normal dosage recommedated by physicians and FDA guidelines. Usually common sense dictates following the instructions listed on the bottle or physician’s orders. Never decide to begin ingesting supplements until your have discussed doing so with your family doctor first. Vitamin D is an important vitamin from strong bones,growth, and for many chemical reactions that occur within our bodies. Moderation is the key to absorbing sufficient Vitamin D. As for sunshine….be careful not be burn ..wear sunscreen protection…
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That’s my comment…pass it on…
Dr Anthony
Vitamin D is in the news again, and while the experts squabble over it, I’m off to buy myself some supplements. The chief medical officer for England has told GPs like me to advise those at risk to take supplements. And since half the adult population of the UK is lacking vitamin D in the winter months and deficiency is being linked to a growing list of health problems, I can’t see a good reason not to take a small multivitamin a day – at least until the sun comes out. I’ll stick to the recommended daily amount as you can have too much of a good thing, even vitamins.
Vitamin D is essential for bone growth and health, and deficiency can cause rickets in the young and a condition called chondromalacia in adults. You wouldn’t think rickets still existed in the UK but it probably never went away and is increasingly recognised as a cause of fractures in susceptible children.
Recently two parents, Rohan Wray and Chana al-Alas, were accused of murdering their four-month-old baby who died two years ago from sudden infant death syndrome (Sids, also known as cot death). The baby, Jayden, was found to have multiple injuries and the parents were accused of shaking the baby to death. But pathologist Dr Irene Scheimberg, based at Royal London Hospital, found evidence of rickets in Jayden at postmortem and the judge directed the jury to acquit.
Since that tragic case, Scheimberg says she has discovered vitamin D deficiency in eight further cases of Sids and in 30 cases of children who have died of various causes and had postmortems. A colleague of hers, Dr Marta Cohen, working in Yorkshire has also found vitamin D deficiency in 18 out of 24 cases of Sids and in 45 babies under the age of one, who died of other causes. Both doctors are calling for further investigation into the implications of vitamin D deficiency and highlighting the need to be aware of rickets in cases of Sids, which can be mistaken for non-accidental injury.
This adds weight to those calling for widespread vitamin D supplementation in the UK. Advice from the chief medical officer for England, Sally Davies, was for at-risk groups – which includes pregnant and breastfeeding women, children aged six months to five years old, people aged 65 or over, people who are not exposed to much sun (the housebound, those who cover up their skin for cultural reasons and people who have darker skin, whose bodies are unable to produce vitamin D as easily) – to take vitamin D. But there have been calls to introduce supplements for all the population in Scotland, because of high levels of multiple sclerosis which may be linked to vitamin D deficiency. Ryan McLaughlin, 13, launched a campaign, Shine on Scotland, in response to his mother’s diagnosis of MS, while Professor George Ebers of the Nuffield department of clinical neurosciences at Oxford University believes the evidence is now good enough to justify dosing the entire population with vitamin D. Professor George Ebers of the Nuffield Department of Clinical Neurosciences at Oxford University is quoted, saying that he believes the evidence is now good enough to justify dosing the entire population with vitamin D. Last month, his team published evidence of a link between MS and an inherited tendency that leads to vitamin D deficiency.
Scotland’s chief medical officer, however, Sir Harry Burns, says in the same article he thinks there needs to be “broader scientific consensus” before change is considered. He warns that dietary supplements can cause harm and that we need to wait for good randomised studies in large populations. He wants to wait for the conclusions of a review of the evidence by the UK government’s scientific advisory committee on nutrition in 2014.
But Ebers says that is too long. He reflects that there was evidence to support recommending folic acid supplementation for all pregnant women to prevent problems like spina bifida, many years before the public health authorities backed it.
Bruce Hollis, professor of paediatrics and biochemistry at the Medical University of South Carolina, agrees, insisting there’s no point waiting for a large randomised trial because it’s unlikely to ever happen. He says it would be hard to attract funding for an expensive, large scale trial as drug companies would be unlikely to make a profit on cheap vitamin supplements.
The best source of vitamin D is sunlight on the skin. Vitamin D is also found in a small number of foods (oily fish, eggs, cheese and meat) but it is difficult to get enough vitamin D from diet alone. In the UK, all margarines and infant formula milks are already fortified with vitamin D and it is also added, in small amounts, to other foods such as breakfast cereals, soya and some dairy products,. Breastfeeding mothers need adequate vitamin D levels of their own to ensure their babies get enough.
You can buy single vitamin D supplements at most pharmacies and supermarkets. Pregnant women who take vitamin D as part of a multivitamin should avoid supplements containing vitamin A (retinol), which can be harmful in pregnancy.
While the experts continue to debate, we may all be well advised to take a daily vitamin D supplement and expose our skin to whatever weak winter sunshine we can.
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