Living in dual liminal states: Navigating the loss of my father and my clinical career during a pandemic

Sitting at home, engaging with a world devastated by grief through my laptop and television screen has been one of the most helpless times of my life, both professionally and personally. Prior to returning for my doctorate degree, I worked for 20 years as an oncology and palliative care social worker. It was my daily mission to support patients and their loved ones as they attempted to make sense of the unknown and find hope in what felt hopeless. Supporting other healthcare professionals as they wrestled with their own professional grief and existential distress also became an instrumental part of my role. Since my transition into an assistant professor position last fall, my job responsibilities have switched to education and research and away from hands-on clinical care. The identity and role adjustments in separating from clinical care and transitioning to academia hit me particularly hard, as I sat idly on the sidelines. I felt helpless witnessing the pain of my palliative care social work peers burning candles at both ends with limited emotional or instrumental support.

Hearing stories of individuals dying alone in hospitals with no permitted visits or opportunities to tell loved ones goodbye made me question career decisions I had made that kept me from being at the bedside helping those dying from COVID. I aborted my research with those living with cancer due to public health precautions that prohibit entrance into health systems, especially with patients in oncology and palliative care settings. Each attempt at offering my clinical skills in volunteer capacities met roads blocks as administrative personnel had more pressing duties than onboarding a new volunteer. I felt overwhelmed by existential distress knowing that I had abandoned my life’s passion and my professional companions.

In addition to the unsettling professional losses that I faced, I also lived amidst the daily uncertainty of my own father’s terminal cancer. In January, as I entered my first semester teaching in an assistant professor role, my father entered into hospice care halfway across the country. My visions of balancing teaching and long-distance caregiving quickly changed as COVID-19 reached pandemic status. While physically and mentally transitioning to online teaching and all the associated challenges, I also woke each day wondering which new distressing symptoms my dad would have and how my stepmom was coping as Dad’s sole in-person caregiver. My eagerly anticipated Spring Break trip back home was stymied for fear that I might bring COVID-19 virus back to my vulnerable parents. Dad and I counted down the weeks until classes would end, hoping that travel would be permitted. What I didn’t realize was that my dad was counting down the weeks to mark the time when he could die with me at his side. Literally, the day after classes ended my dad’s health changed dramatically and he became non-communicative. Three days later I received “the call” letting me know that I needed to get home right away.

As you may have experienced with your own loved ones, the final days of life bring tremendous sorrow and sometimes, unexpected opportunities. My family somehow managed to work within COVID visitation restrictions so that my brother, stepmom, and I could each visit Dad at Hospice House at least every other day. We exchanged many tales about Dad’s life and discovered common themes interwoven throughout the stories that centered on his love of creating educational opportunities and ways to instill humor in the most distressing situations. I reflected that even though I don’t have the stomach to follow in my dad’s footsteps as a veterinarian, I often emulate his skills in comforting the grieving and also have a fondness for embracing teachable moments. Although my dad couldn’t speak those final days, he sometimes opened his eyes when we shared stories, and for a couple precious moments, squeezed our hands in recognition of something we shared. These glimmers of recognition became priceless and none more so than the last night of my dad’s life.

While sitting with my stepmom at Hospice House, watching my father approach his last hours of life, we talked about my students and the touching, 18-page, thank you card they emailed me the morning after classes ended. She was tickled to hear their feedback and suggested that my dad may want to hear their words of appreciation. So, I carried my laptop up to my dad’s beside and read some of the students’ compliments right by his ear, hoping that indeed, the sense of hearing was the last sense to leave the body. After I finished reading the students’ comments, my stepmom took my dad’s hand and asked him:

Did you hear the beautiful comments Jennifer’s students had about how she changed their lives and what a remarkable teacher she is? I know you must be so proud of your Jennifer. Squeeze my hand and let me know if you heard and let us know how proud you are of Jennifer.

I don’t know where my dad found the strength, but he flexed his muscles and squeezed my stepmom’s hand, acknowledging his pride. My father died several hours later with me alone at his bedside.

Due to the COVID-19 health department visitation restrictions, I was not able to have loved ones there to support me during these traumatic final hours. Instead, I had to garner the strength to live through these moments and gather my thoughts for how to tell my stepmom and brother that my dad had died. All those years of training and life experiences never prepare you for your own rites of passage or for the additional challenges that a pandemic can bring to the dying process. My training taught me to hold the news of dad’s death until my family members were in a safe space to receive this news. However, I never gathered knowledge to prepare me how to tell my brother in the Hospice parking lot, at our exchange of caregiving shifts, that our father had just died. Not being permitted to be present with my family as they said goodbye to Dad went against everything I had learned about being a good social worker and caring family member. As I left my family behind at Hospice House, my thoughts shifted to the families who had a loved one die with the coronavirus and were not permitted to see or speak with their loved ones. I pondered the ways in which their unanswered questions and inability to say goodbye may complicate their grieving process.

In life, sometimes the smallest actions can lead to unanticipated affirmations. When my dad squeezed my stepmom’s hand in recognition of my teaching achievements, I began to acknowledge that although I am no longer providing hands-on care to families and peers in the clinical trenches, my decades of bedside experience will not go to waste. I can transition my passion and professional experiences into my social work pedagogy, cultivating my students’ clinical skills, thirst for knowledge, and their confidence to embrace the multitude of professional and personal challenges they will encounter. The final days at my father’s bedside also afforded me time to reflect on the insider privilege I have acquired during his illness and dying process. Albeit painful, my rites of passage in losing my father have offered me an unique insider perspective of the lived experiences of caring for and losing a loved one during a pandemic. These insights have led to the generation of several qualitative questions that I can apply in my research to illuminate the challenges, barriers, and opportunities that result from caring for oneself and others during the time of a pandemic.

As I write on the day following my first fatherless Father’s Day, I hold gratitude for the momentous and mundane times I was able to share with my dad through his life and extended illness. I also ponder how my dad, even though he couldn’t speak, found a way to furnish me with these last teachable moments. My existential quest during the COVID-19 pandemic enabled me to reflect on my personal and professional rites of passage through separation, transition, and into incorporation (Van Gennep & Caffee, 1960). Although not a fait accompli, I have a clearer understanding of my path forward and how I can incorporate my new identity, roles, and purpose into a life of meaning.