Twisted Grief with Grandma's Memoir

By KJ Leigh

What a mess. Life doesn’t get more challenging than when KJ aims to diffuse hospice myths and drop a few bombs in 2020. According to the statistics, most people experience uncomplicated grief after a loss, but what about the rest of us? The hot mess expresses. KJ has leaned into the discomfort and let go of today’s cultural normalities to process grief in a healthy way. Based on the five stages of grief, Twisted Grief provides insight into the method behind the madness in an attempt to shine light in a dark place.

• Language: English
• Publisher: Christian Faith Publishing, Inc.
• Release date: Jun 10, 2024
• ISBN: 9798892436458

Book preview

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Twisted Grief with Grandma's Memoir

KJ Leigh

ISBN 979-8-89243-644-1 (paperback)

ISBN 979-8-89243-645-8 (digital)

Copyright © 2024 by KJ Leigh

All rights reserved. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods without the prior written permission of the publisher. For permission requests, solicit the publisher via the address below.

Christian Faith Publishing

832 Park Avenue

Meadville, PA 16335

www.christianfaithpublishing.com

Printed in the United States of America

Table of Contents

For my grandma, Momma, my aunts, my daughter, my little brother, my father(s), and my sisters in Christ Jesus. In His name, I pray that only Him, can call you by name and all of God's children said amen.

Grandma, thank you for the stories. I will always cherish these memories. They are magical. Just like you. I will tell my momma to feed the hummingbirds.

XOXO

I love y'all.

Foreword

Introduction

Chapter 1

Hard Conversations

Chapter 2

What Is Grief?

Chapter 3

The Explosion

Chapter 4

Into the Night

About the Author

For my grandma, Momma, my aunts, my daughter, my little brother, my father(s), and my sisters in Christ Jesus. In His name, I pray that only Him, can call you by name and all of God's children said amen.

Grandma, thank you for the stories. I will always cherish these memories. They are magical. Just like you. I will tell my momma to feed the hummingbirds.

XOXO

I love y'all.

Foreword

The World of KJ

Oil in Our Lamps (The World of Mary Davis Brown) was self-published in 2010 by the descendants of Mary Davis Brown. My grandmother was a member of the publication committee. She's ninety-two and still lives in York, South Carolina. As in Oil in Our Lamps (The World of Mary Davis Brown), York County, South Carolina lies on the border with North Carolina in the area known as the Piedmont, the foothills of the Blue Ridge Mountains that cut across northern Georgia, and the western Carolinas and Virginia. It was here I was born, and it was here that I lived. Like most rural families, the church was the center of life, and in York County, that originally meant the Presbyterian Church, a legacy of the heavy settlement by Scottish-Irish Presbyterians during the last half of the eighteenth century.

Just like my ancestors, I believed, if nothing else, that my writings could demonstrate to the modern reader just how important family and religion were for rural Southerners. After all, this held true for many women in my family. Not only could my family shine a light during the twentieth century, but now I could also shine a light on the twenty-first century. Like an acolyte on Sunday morning, walking down the main aisle of the sanctuary and trying to not let my candle be blown out, I finally knew what my purpose was. I had to keep my candle lit. I just had to find a way to do it. Navigating around the air vents down the main aisle to the altar. My ancestors were not playing around when they used oil in their lamps.

When I was six years old, we moved from the East View area to a small, quiet town on the other side of the county. There is so much love there. There were also good schools, and I spent my childhood there. My family raised western horses, and my twin brother, AJ, and I spent our time traveling in the Southeast and Western States, rodeoing. During our senior year, we were known as the Rodeo Twins. AJ was the reigning bull-riding champion, and I was the reigning rodeo queen for South Carolina. I also spent ample time as a competitive swimmer and learned how to be a disciplined athlete. I moved to Clemson, South Carolina, to attend Clemson University at the age of seventeen. I was a wildflower in a lecture room. I was lost in ambition and went undeclared with a focus on preprofessional health studies.

When I was a toddler, I survived a brain tumor, specifically an Astrocytoma, and after ten years of follow-up visits at Richland Memorial Children's Cancer Institute in Columbia, South Carolina, I knew I needed to be in the medical field. I could perform an entire neurological exam by the age of thirteen and hold an intriguing conversation with a team of doctors. I had a future there because I had been through it, and I was passionate about it. I had always heard that if you love what you do, you'll never work a day in your life.

My twenties were tricky. I was a small-town Southern girl, who fell in love, got pregnant, had a baby, and married all by early 2010. I left the university and attended trade school. I was licensed in cosmetology and worked in a salon for a few years. Life was grand until it wasn't. We were a struggling blue-collar family, and I was better off at home than paying for childcare. I had to find something to occupy my time. I've always been something of a busy bee. I went back to school online and finished the prerequisites for a nursing program.

Go to nursing school, they said. It will be fun, they said.

I found myself reading Oil in Our Lamps (The World of Mary Davis Brown) repeatedly for comfort. Even on the worst days, it gave me hope and motivation. When I separated from my husband, Richard, in 2015, I was mortified to tell my grandmother. He is the father to our only child, but I was young and too proud to fight for him. When I finally worked up the nerve to tell Grandma, she said, You'll be okay. I did it, and I was okay. You will be too. She was right, and I am okay.

I come from a long line of hard-working, successful, independent women, and I always knew that I wanted more than what I had. I wanted to make the best life for myself and my daughter. My daughter deserved a mom she could be proud of. I worked diligently to finish nursing school and made a single-parent home to AK. I did my best, but I wasn't satisfied. My purpose had not been served.

Introduction

Year 2020, it's been a long, few years for AK and me. We are still settling into a new home near the lake. I have spent much of my nursing career working in hospice and palliative care. Hospice is my calling. One of many that I've learned in my short years here on earth. I've had multiple people from near and far tell me that hospice is a calling, but not until recently have I really started to believe that hospice is my calling. After a few job switches, it's blatantly clear that I am in the right place for my specialty.

During the last few death visits I have made, I have been remarkably overwhelmed by the peace I have on the way home. I routinely listen to Go Rest High on That Mountain by Vince Gill. It's my mantra for them. Traditional services are few and far in-between these days, and it's how I honor them. Strange, right? But it's not strange because that's my job and a good day for me, especially those oddly perfect death visits where it's one of your favorite patients and they were physically comfortable, and all their favorite people kissed them bye and told them it was okay to go. The Mommy, you helped them go to heaven statements from my daughter when I walk in after an on-call visit at 5:00 a.m. I've never really hid what I do from her or tried to pull the wool over her eyes with the false hope that life is all fairies and rainbows. I've also never really made it a big deal. To her, it's just what I do. I help in hard situations. I shine light in dark places. Hospice is so special that it saved me. This is where I put pen to paper. This is how I would glorify God in my life.

Mary Davis Brown had no say in the decision to publish the revealing contents of her writings for Oil in Our Lamps. Her descendants assumed this responsibility and I believe she would be honored and humbled by the accreditation. Words are worthy of being preserved and shared. I believe that I am not only honoring her, but also I am helping make the history of my era richer, and more complete. Just as her writings did, I want to share my stories and reflect on the humility and faithful dependence on God for strength to face life's challenges.

She led a simple life, but she was not a simple person. Amazing in her ability to express herself with her limited education. (Oil in Our Lamps)

I began recording my thoughts, prayers, and daily activities in a rural community of York County at an early age but was never consistent until my adult life. Just as, Mary Davis Brown, I was thirty-two years old when I committed to writing. I am a mother, caretaker, and teacher to one beautiful daughter, AK. I am a daughter, sister, friend, nurse, and lover, and that barely scratches my surface. I come from a beautifully blended family. Both of my parents remarried and extended the family to half of York County. My mother is Rhyne Montgomery, married to the love of her life, Morgan Montgomery. My father is Lance Monroe Johnson, married to the love of his life, Patti Jo Johnson. I was raised by all my parents and am humbled by their love. I am the twin sister to AJ. He has married twice and given me lifelong friends with both ladies. They are both precious, and each earned a jewel on their crown for dealing with AJ. I am only half joking. I love AJ so much. He is my best friend for life. He has a large, extended family, and their home is now a frequent gathering place for family, neighbors, and visiting friends. As I put pen to paper, I am writing to express my pain and tremendous sadness during a period of grief. I feel through my words the heartache of losing someone.

We learn that her faith in the Lord provided the solace and strength needed to face another day. We have no record or no knowledge that she kept a diary before this date, but from that day forward, Mary shares with us her family and the people and events that make up the fabric of her life. The diary of Mary Davis Brown gives her descendants and anyone interested in the history of upstate South Carolina a unique snapshot as she matured from a young mother to a wise sage and observer of the world around her.

2020

And I will light a candle for you,

To shatter all the darkness,

And bless the times we knew.

Like a beacon in the night,

The flame will burn bright,

And guide us on our way.

Today I will light a candle for you.

—Agape Hospice

1854

Thou art gone to rest in a lonley bed

Sweet form of my lovely child

In the silent grave rests thy little head

And hushed is thy voice so mild

Asleep in Jesus blessed sleep

From which none ever wakes to weep.

William Given Brown departed this life Octoba the 6 on fryday evening at six o'clock, 1854

So William lives but not whare time

Is measured out by woes

Not whare cold winter chills the clime

Ore cancor eats the rose.

—Unknown

Chapter 1

Hard Conversations

I was a new graduate nurse working the night shift in a critical care unit when I learned how to have hard conversations. The conversations on advanced care planning, advanced directives, code status, and proper education of a legal and signed DNR consent. If final arrangements had been made and what funeral home was the preferred choice of the family, the conversations with the locum intensivist told you to keep the patient on pressers and titrate to maintain minimum systolic blood pressure. Basically, to maintain a life regardless of any potential loss of quality. You don't learn how to interpret and respond to those topics in a blind fashion quickly. I had those talks regularly. In fact, it was a pretty seamless transition when I made the specialty move to hospice and palliative care after a year of inpatient bedside nursing. Hospice and case managing in the community was mostly education at the bedside. Plus, I grew up in this area, so people knew my family, and they were easy to talk to. Hospice 101, build a rapport with your patient/family, educate, get orders for comfort medications early, and follow Medicare guidelines. That's what makes a great hospice registered nurse case manager. Sounds easy, right?

Once I was settled into hospice and had worked as a case manager, on-call nurse, and held various positions in leadership, I had a dialogue or script for hard conversations. I knew how to have those conversations and check all my care plan boxes from beginning to middle to end but, by no means, is being a hospice nurse ever easy. A lot of the time, my favorite patients were stoic veterans. They were a challenge because they often shut down when tough subjects came up. They didn't show the textbook signs and symptoms of pain or distress whether it was physical, emotional, or even spiritual. They were the patients that I really had to love and be crucially transparent with. I had to earn their trust because I was the one person, they knew that would be there at the end. Arguably, one of the most vulnerable moments in their life. They had to learn to trust me. It is honorable to take care of patients at the end of life.

Somehow I had to educate my patients and corresponding families well enough to trust me with their pain, hurt, and grief. How do you teach someone it's okay when it's not okay? How do you teach someone that all they know and have here on earth is temporary and coming to an end? You have to rush the beast always stood out when addressing a failed plan of care or even a grievance. Talk about the problem. Talk about the elephant in the room. It's okay to be hurt, it's okay to feel the pain. These are basic human responses, so we are allowed to talk about them, and we are certainly allowed to feel them. During a hospice admission, I called it, the look, when patients would stop and study me for answers when I asked tough questions.

In an attempt to comfort them, I would explain that it was my job to have these hard conversations. Layers of education were always my weapon of choice when I had a challenging case. I had a few years under my belt, and I was certified in hospice and palliative care nursing, so I was the expert in the room. It sounded dark and stormy, but it wasn't. It was breathtakingly eye-opening. I was telling these people the truth behind their terminal prognosis. If I was lucky, they were accepting and open to hospice services. Those decisions were autonomous in broad daylight. In a world where patients believed they had lost control of everything in their lives, I was sitting there, telling them to decide. To be hospice-minded or keep fighting?

My hospice patients were special. I learned to love them all in different ways. I see all walks of life. Once my patient learns to love me too, they would ask the question, So how long? Ultimately, I didn't know because I wasn't in control. I could only do what I could do and provide education. I would educate them on the hospice philosophy and the core components of the quality vs. quantity evidenced-based practices. Education was my defense mechanism. I would quote Abraham Lincoln and say, It's not about the days in your life but the life in your days. It was a state of mind and a manner of existence that was the essence of hospice. Add life to their days, not days to their life. It was truly that simple.

The sandwich method. A very brilliant mentor once taught me about the sandwich method (bread, meat, bread). This was actually taught during a leadership conference, and she utilized the reference to address challenging employees. It worked very well for me during my time in hospice leadership so when I went back to bedside nursing, it just worked there too. Some things just aren't fun to talk about. So you used the sandwich method. The bread was the easy part of the hard conversation.

During a hospice admission, this is where the nurturing nurse educates on how she is here to help you carry your burdens and not add to them, by offering not only the support of a hospice nurse but also an entire interdisciplinary group of experts on end-of-life care. That way, the family member providing around-the-clock care to the patient would get to spend the next few days or weeks holding the patient's hand, reflecting, and grieving. Grieving starts way before the loss occurs. Playing your role during that time is very important. Be the spouse, be the child. Please let me take care of them so you can grieve because it's coming. It is coming.

Per the sandwich method, then came the meat of the hard conversation. The not so fun part of the hospice admission conversation. Consents. Legally signed consents. Sign here so I won't do CPR. Okay, that was morbid at the beginning of the book, but remember this is my job. There is absolutely no way to sugarcoat or make a Do Not Resuscitate Order and Authorization for Natural Death sound warm and fuzzy. There's just not. So you sandwich it in there during the meat part of the sandwich method and move on.

The second piece of bread for a hospice admission was the medication reconciliation, equipment orders, supply orders, and the hospice assignment. If the patient and family agreed to hospice services, I got to reconcile medications to remove pill burdens, order the hospital bed so they could be more comfortable, and order their incontinence supplies because that financial responsibility was now hospice-related and covered. Finally, I was able to assign each discipline to provide help and care throughout their journey. A hospice nurse, a hospice CNA, a medical social worker, a chaplain, and a volunteer if needed are all part of a hospice case assignment.

It is honorable to take care of patients at the end of life, and hard conversations were just part of the job. Many times, I had families ask me, How do you do this? but I never had a solid answer. I just did it. I was young, and I hadn't experienced death on a personal level at that point in my life. So I went to work and loved on my patients as long as I had the honor of doing so, and then when the time was right, I'd let them go. I knew my time with them was temporary. I had patients for hours, days, weeks, and months. Some patients were terminal and slowly declining. Other patients transitioned from actively living to actively dying in a matter of hours. Some patients wanted to die and held on for what seemed like forever. Other patients didn't want to die but just couldn't hang on any longer. I never had the same patient twice, but that's what made hospice so special to me.

After each patient, the world keeps spinning. Life goes on after death, and everything here on earth is temporary. As a young and oblivious hospice nurse, I believe that's how I stayed so strong doing it. I pretended it was all okay, even when it wasn't. Rationalization was how I processed my grief a few years ago. It's how I process my daily job and its science, so it just followed in my personal life. Do your patients die? Yes. Almost all of them, but that's what I'm there for, so is that rationalization? People die all the time.

Literally and figuratively, people die of broken hearts all the time. Anatomically they are not 100 percent, and their body goes into fluid overload, which causes congestive heart failure and subsequently multiple organ failure with vascular and renal disease. It's disheartening to witness the constant shortness of breath and the swelling and weeping of the lower extremities. Their heart is not operating at full potential anymore, and that's okay because we are only made to live so long. Like the placenta of a carrying mother, after so long that organ has served its time. It has served its purpose, but it's not okay at the same time because there's a struggle, a physical struggle. You have no choice but to accept it. It's part of life. Struggling is part of life, but the hardest people to watch pass on hospice services are the ones with broken hearts that just never quite healed right. The people who have unsettled disputes and the ones holding onto grudges from years of pain. The ones that never let go of their mistakes or smoothed over rough patches. The ones that are brokenhearted because not a single family member or friend is at their bedside at the end of life.

This is when hospice tugged at my heartstrings. Although the actual death part didn't bother me, the heartbreak did. I knew how it felt during the dark, lonely hours of the night. I was all too familiar with the dull ache of hollowness in my chest. When I filed for legal separation from Richard in 2015, I lost a piece of me. For the past five years, I have been grieving the loss of my marriage. Sometimes I still grieve. There is no way I can be the only thirty-two-year-old female who hates sleeping alone. I was so good at pretending it was all okay though, even when it wasn't. I did it at work, and I did it at home. I didn't even know I was grieving. I didn't even know my heart was broken because I pretended like it didn't hurt. I moved on and chased purpose.

Obviously, I wasn't here on this earth to be a wife, so I focused on my daughter and career. AK was in kindergarten when we separated. She has always been a daddy's girl, and our joint custody agreement gave me a lot of spare time, so I buried myself in work. As a southern girl, my family didn't fully accept me being a single woman. My overprotective twin brother certainly didn't approve of me dating. So in any leftover time, I kept to myself and coped with alcohol use, smoking, and bad taste in men. From my education and clinical experience, I should be able to process grief like a champ, right?

2020

Maybe you've been

assigned this mountain

to show others

it can be moved.

1854

Oh by how weak and frail a thing

May the hearts deapth be stird

How close and long will memerry cling

To one light look one word

Well he is happy now dear children

His ransomed soul has fled

He feels no more earths hollow joys

Or real misery

I strove indeed to breath thy will be done

But it was hard to say

Nature clings hard and fast

To such a child as dear William was

Chapter 2

What Is Grief?

Grief is a therapeutic process that includes cause-and-effect reactions to learn, recover, and grow from a loss. We all experience loss, and we utilize the grieving process to develop coping skills and move forward. From a nursing perspective, grief is comparable to pain, meaning it is subjective. It is whatever the patient says it is. Grief is not a weakness or caused by a lack of faith. It is a complex and honorable emotion and includes love, anger, frustration, fear, bewilderment, and loneliness. Most grief reactions will eventually diminish in severity as a person utilizes resources that enable them to recover from traumatic experiences. The primary cause of grief is some type of loss. There are a variety of losses, and each is different for every individual. Grief is the emotional response to the inner experience of saying goodbye. There are many emotions of goodbye that come to the surface as we part ways with something or someone in life. Goodbye is a difficult word.

Mourning is the outward social expression of a loss. It is influenced by cultural normality, religion, and practices. In many cultures, mourning signifies respect and promotes the expression of feelings by the bereaved. Physical manifestations of grief can include shortness of breath, tachycardia, insomnia, muscular tension and headaches, tiredness, loss of appetite, restlessness, vulnerability to illness, and sexual dysfunction. Psychological manifestations of grief can also occur affecting behavior, emotions, and cognitive function. Although each person may express grief differently, some aspects of grief are shared by almost everyone.

Grieving is a fluid, ongoing process. There is a constant movement among stages, including recurrences of phases that were thought to be resolved. There is no single, correct way to grieve according to four major theorists in the field. Engel (1961) focused on three stages of grief and believed that uncomplicated grief is universal and does not require treatment. Bowlby (1982) broadened the theory of grief with his idea that it is a mature way of dealing with loss of attachment. Rando (1984, 1986, 1993, 2000) identified the process and stages of grieving, commonly described as the six Rs of grieving:

Recognizing the loss (awareness)

Reacting to the separation (feeling the emotions)

Recollecting memories (remembering, reliving)

Relinquishing the old attachment (new ways of living)

Readjusting to the new environment (new coping skills)

Reinventing self (energy once turned inward on grief begins to be focused outward again).

Worden (2002) described the four tasks of grieving and the progression of working through pain and grief to move on with life. No two people grieve in the same manner due to the factors that play a role in the process. The meaning or significance of the loss will be different for each person. The amount of support, existing conflicts, circumstances, and timeliness of the loss will also be different. Spirituality and religious beliefs can help the grieving process. Grief can be categorized in several ways, most of which have to do with timing and intensity. Complicated grief, chronic grief, masked grief, delayed grief, and disenfranchised grief have been distinguished from uncomplicated grief (normal grief). Death and dying is the ultimate loss. At the end of life, a dying person faces the loss of physical control and function. The dying person ultimately loses physical life itself. Not the life everlasting.

In North American culture, Western medicine is still growing rapidly, and death is not seen as a natural part