The past 4 weeks I have been kept momentously busy doing my cardiology rotation for PA school. This rotation hit home too often to count. Since I have joined the sisterhood of widows, I have gained many truly wonderful friends who lost their husbands suddenly due to a heart condition. As I treated those patients in their beds, I couldn’t help but remember the faces of those that have gone before us, those who left behind loving wives and beautiful children. I dedicated my time spent as an act of prayer, a prayer for the families left behind, a prayer for the souls of the dead, a prayer for the caretakers of the patient, and of course a prayer for the patients themselves.

I wake up every morning asking God to make my life a constant prayer, to remember Him in every moment, to honor and love him in all that I do. And on the days that are the hardest, I repeat incessantly “I can’t do this on my own oh God, so Jesus I offer it up to you.” This has become part of my daily prayer. Because behind these eyes, behind this smile I put on my face, there are still so many moments where the pain stabs me so hard that my heart feels like it stops and I forget how to breath. These moments may only last a few seconds or they may last hours. Every day is a new day. Every moment brings a new memory, a new challenge, a new hope. I do my best to find the hope but no matter what there is always a shadow – a shadow that will forever linger on every moment of every day, every joy, every accomplishment, every change.

As I studied throughout my rotation last month it struck me how much I am taught about the different characterizations of chest pain and what it means, and yet there is no mention of the pain of a heartbreak. A discomfort that feels like a pressure, heaviness, tightness, fullness, or squeezing often indicates a cardiac ischemia. Whereas an aortic dissection most often presents with the sudden onset of sharp, severe pain, often characterized as tearing or ripping. Pain that occurs in the chest wall that is sharp and worsened with breathing is often pulmonary in nature. (Note: these are not diagnostic descriptions, but common generalizations among medical practice). I find it kind of funny, as I read through these descriptions, because as frightening as these conditions are, the pain that is described does not even come CLOSE to the pain of a heartbreak.

This pain is so raw, so excruciating that truly no words can describe it. It is feeling that your heart has been stabbed, then ripped out of your chest. Thrown on the ground and shredded, then haphazardly sewn back together and shoved back inside. It hurts so much you can’t breath. You can’t think. You can’t process things around you. You’re lucky if you remember your name when this pain hits, it is truly shell-shocking and numbing. All you can do is wait, wait for it to go, wait to wake up from this horrible nightmare, to go back to the way life was before.

The problem is, there is no going back. There is no “cure”. The only step is moving forward, moving to a new “normal”. However I can’t find a treatment plan or medication in my books to help with this. There is no “one way fits all” kind of cure. And that often is the worst part. Because, the heartache, as much as it hurts, is only the tip of the iceberg. The loss of someone you love, particularly a spouse, not only creates a pain so unbelievably deep, it also creates a void in your life. A loss like no other. I still struggle every single day with what my life means without Nate in it. I still have trouble figuring out what my immediate future should look like because all the thoughts I ever had about the future had him in it and had him there beside me to make decisions. I am unprepared and uprooted.

I remember reading last summer a list of the types of losses you endure when you lose someone you love. There is the primary loss, which is the ache of the person gone from this earth. Then there are the secondary losses, which are so numerous; yet each one is such a deep loss, its own kind of pain. These secondary losses are the ones that no one talks about. Because unless you have suffered this type of loss, the pain of these secondary losses is unfathomable. These are the reasons why those of us who have lost our spouses can’t “just move on” from our grief in a “timely” manner. It is the reason why it is so incredibly difficult for me to do anything, why my brain feels like it is turned to mush all the time. Why I can’t figure out my future, because these losses are just unbearable and often impossible to comprehend. My entire life has been upturned and thrown into disarray. These secondary losses can include:

• Loss of ourselves – Nate was not just my husband, when we were married, he became a part of me. Half of me was taken when he left, I am no longer whole, I am just a shadow of who I was when he was here.
• Loss of identity – Now that half of me is gone, I have no idea “who” I am anymore. It is so hard for me to hear people say that “the old Jen is back”. I know they mean well, but my heart can’t help but cry out – how can the old Jen be back?!? She is gone, buried with him. While I am not going to drastically change into an unrecognizable person, I am also never going to be the same again. That old Jen that people used to know is gone forever.
• Loss of self-confidence – People tell me I am strong, but I feel like all I have to do is get out of bed for them to say that. I suppose there is a strength in me that keeps me going, but I feel that my confidence has been shattered. If people say rude or hurtful things I just want to crawl under a rock. I often just don’t have the energy to stand up for myself and even if I do, I just don’t have the desire to.
• Loss of security – this is a big one! When you lose someone, your entire world is rocked. The way I lost Nate rocked it far more. The security I feel around the world is gone, safety is one of the biggest things I value and I have the hardest time trusting anyone that isn’t within my small circle of daily confidants.
• Loss of financial support – So much of my livelihood and future was surrounded by Nate’s income and career. He was so excited to start working in November at his new job because it provided such a good outlook for the future. I hate how short his life was cut, how he only had just begun working at his dream job, how he had just began to feel comfortable there, and we were beginning our savings plan for our future family – the family we no longer can have.
• Loss of family structure as it was once known – We wanted many children, a huge family and a home filled with laughter. I never imagined it would just be Cecilia and I. It breaks my heart over and over and over again, not just for myself, but for her, for all of the siblings she is missing out on, for her not getting to grow up with her daddy, who would have loved her more than life itself. This is one of the hardest losses to bear.
• Loss of “dreams” – we had so many dreams together. I can recall so many conversations of silly dreams I had, things I wanted to do with him, places I wanted to go, our dream house, etc… He always would just smile at me and tell me “ok”. He once promised me he would fly me to Paris one year on a secret weekend getaway, one where he would just whisk me away for a quick trip, just the two of us.
• Loss of the future – Again, how can I have a future without him? He was my future. Every future plan I ever built was built around him, around us.
• Loss of direction – The path I was on is no longer an option, I can’t go forward down that road anymore because that was only a road to be shared with Nate. At the same time I can’t go back either. How do you know what direction to go when you can’t move forward or backward the way you came?
• Loss of shared goals – we had so many goals in life we were working towards. Recently I have entertained the thought of buying a house. But even the thought feels so strange to me. I was supposed to do this with him – it was our goal to reach together. I feel so cheated.
• Loss of daily sharing – he was “my person”. I still reach for my phone to call him. Or stare at it, thinking he should be texting me any moment. I miss his voice, I miss his input and opinions, I miss having that person that I can share anything and everything with. There truly is no other relationship quite like a husband and wife, where 2 people are so united as one they know each other better than themselves. He’s the only person who could help me through any loss. When you lose someone outside of your spouse, you have them for support, when your spouse is the person you lose, your entire backbone of support is shattered, throwing you to the ground like a mere ragdoll.
• Loss of control – Losing someone you love is often out of your control. When you lose this, you find yourself feeling that so much is out of your control and it all begins to spin around and around and around. Control truly feels like such a foreign concept. Because if I had any control, I would bring him back to the life we were supposed to have. This one is something I have prayed about often – I have prayed about this, prayers to ask God to take control, to allow Him in and trust Him fully. In some ways, the loss of Nate has allowed me the ability to give it all to God, because I have no other option but to trust Him.
• Loss of decision-making ability – I cannot express how much of a struggle this one is. The ability to make decisions is SHATTERED without Nate here. It is almost as if my brain is on standby, unsure of what to do next and choosing to stay put rather than go forward or make any changes.
• Loss of patience with self and others – This one I struggle with, and it shocks me that I do. It is a loss you wouldn’t think of if it didn’t happen to you. I find myself impatient with those who are caught up in trivial concerns, things that seem so unimportant for me since Nate died. Through prayer I am often able to overcome these feelings but sometimes still catch them crossing my mind nonetheless.
• Loss of health – those who suffer great loss often suffer health consequences. There is an increased risk for many illnesses and diseases as well as heart failure. Those who don’t suffer a specific diagnosable illness, overall have a decrease in health and the feeling of being healthy.
• Loss of humor, happiness, and joy – No matter what joy, humor, or happiness life brings, there will always be a shadow of loss and sadness, a shadow of the person who should have been there to join in these moments with us.
• Loss of residence – a somewhat trivial loss but a great loss all the same. The morning I lost Nate I moved out of our house to my parents and have not gone back since. The loss of our home, the life we had known there is so great. I can imagine that anytime one moves from one home to a new one, there is a certain distress in leaving a home filled with so many memories. When one is thrown quickly into a new life without the chance to say goodbye to their old life, their old home, their old memories, the trauma is so much greater.

The losses of life are so numerous and great, hence why I am so grateful to God that the joys and love of life are even more numerous and greater. The love I feel for Cecilia is so wonderful and full that it fills my heart. The hope and joy that God provides me is what gives me the ability to overcome these losses, one step at a time. I still have a ways to go, a long windy road ahead; but slowly each day I am learning to live again. Learning to figure out God’s plan for me and where I am meant to go next, heartbreak, shadows, and all.

Jennifer Trapuzzano